{"title":"Instructor-Assisted Synchronous Online versus Face-to-Face Suturing Training: Effects on Learning and 3-Month Retention in a Randomized Controlled Trial.","authors":"Ezgi Ağadayı, Arif Onan","doi":"10.1177/15533506251374837","DOIUrl":"https://doi.org/10.1177/15533506251374837","url":null,"abstract":"<p><p>BackgroundThis study evaluates the learning and retention of basic suturing skills among pre-graduate medical students through instructor-assisted synchronous online (ASO) vs face-to-face (FF) instruction.MethodsA randomized controlled experimental design was used in the practice laboratory of Cumhuriyet University Faculty of Medicine. Sixty second-year medical students without prior suturing experience were randomly assigned to FF or ASO groups. Both received identical training with the same materials and instructor. Performance was assessed via the Objective Structured Clinical Examination (OSCE) 1 day after training and again after 3 months. All assessments were conducted in a single testing room by a blinded assessor. The required sample size, determined via G-Power, was 42, but 60 eligible students participated.ResultsThe FF group outperformed the ASO group in both the first (28.3 ± 4.5 vs 23.5 ± 5.6, <i>P</i> = 0.001) and second OSCE (30.3 ± 4.7 vs 25.5 ± 5.7, <i>P</i> = 0.001) and completed the first exam in a significantly shorter time (<i>P</i> = 0.029). The overall average score improved in the second OSCE (27.9 ± 5.7 vs 25.9 ± 5.6, <i>P</i> < 0.001), but score changes over time did not significantly differ between groups (<i>P</i> = 0.927). The cut-off score for adequate knot-tying ability was 25.5 in both exams.ConclusionsThis study aimed to adapt face-to-face surgical training to an online format, as guidance on remote technical skills instruction is lacking. While the standardized online setting ensured methodological consistency, it limited real-life applicability. FF instruction yielded superior short- and long-term outcomes in suturing skills.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251374837"},"PeriodicalIF":1.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969844","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}
Salvatore Giordano, Veera Korhonen, Andre' Salval, Pietro G di Summa, Carlo Maria Oranges
{"title":"Ligasure Impact™ to Reduce Complications After Abdominoplasty: A Meta-Analysis of Comparative Studies.","authors":"Salvatore Giordano, Veera Korhonen, Andre' Salval, Pietro G di Summa, Carlo Maria Oranges","doi":"10.1177/15533506251374484","DOIUrl":"https://doi.org/10.1177/15533506251374484","url":null,"abstract":"<p><p>BackgroundThe optimal dissection technique for flap elevation in abdominoplasty remains debated, particularly in high-risk patients after massive weight loss. The LigaSure Impact™ (LS) vessel-sealing system (Medtronic, Dublin, Ireland) is an advanced energy device used across surgical disciplines to reduce morbidity. This meta-analysis compares LS with conventional techniques to assess its effectiveness in abdominoplasty.MethodA systematic literature search identified relevant studies comparing LS with standard methods. Primary outcome was the overall postoperative complications' rate; secondary outcomes included specific wound complications, operative time, and hospital stay.StatisticsA random-effects model was used for pooled analysis. Risk differences (RD) and 95% confidence intervals (CI) were calculated for categorical outcomes; mean differences (MD) for continuous outcomes. Heterogeneity was assessed using the I<sup>2</sup> statistic.ResultsThe search yielded 3 studies totaling 205 patients. LS significantly reduced overall complication rates compared to controls (RD = -0.46, 95% CI: -0.60 to -0.32, <i>P</i> < 0.001). Hematoma and wound dehiscence incidences were significantly lower (<i>P</i> = 0.03 and <i>P</i> = 0.01, respectively). No significant differences were observed for seroma, infection, or fat/flap necrosis. LS use was also associated with reduced re-operation rates and shorter hospital stays, though operative time was comparable.DiscussionLS may improve surgical outcomes in post-weight-loss abdominoplasty patients by reducing complications and hospitalization. However, the limited number of studies and small sample size warrant cautious interpretation.ConclusionPreliminary evidence suggests that LS may offer potential benefits in abdominoplasty; however, current findings should be interpreted with caution because of limited quality and heterogeneity of available studies. Further research is needed.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251374484"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969758","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":"Redefining the Role of Minimally Invasive Surgery Fellowships in the Modern Surgical Era.","authors":"James R Burmeister, Aryan Arora","doi":"10.1177/15533506251374462","DOIUrl":"https://doi.org/10.1177/15533506251374462","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251374462"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969826","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}
Julian Fine, Russel Kahmke, Tammara Watts, Daniel Rocke, Liana Puscas, Maragatha Kuchibhatla, Walter T Lee
{"title":"Comparison of ENLYT<sup>®</sup>, a Portable Flexible Nasopharyngoscope, with the Standard of Care Nasopharyngoscope.","authors":"Julian Fine, Russel Kahmke, Tammara Watts, Daniel Rocke, Liana Puscas, Maragatha Kuchibhatla, Walter T Lee","doi":"10.1177/15533506251374480","DOIUrl":"10.1177/15533506251374480","url":null,"abstract":"<p><p>ObjectivesThis study seeks to compare a newly developed portable flexible nasopharyngoscope (ENLYT<sup>®</sup>) to the standard of care (SOC) flexible nasopharyngoscope.MethodsSubjects were consented to undergo a nasopharyngeal scope exam using ENLYT<sup>®</sup> after SOC nasopharyngoscope examination. Data collection included a physician feedback survey consisting of questions regarding ease of use, video quality and perceived patient pain. Additionally, subjects provided a comparison of discomfort between the two scopes.ResultsThe following results were compiled from nine examiners completing ENLYT<sup>®</sup> exams on 50 patients. The nine examiners consisted of five attendings, three residents, and 1 physician assistant. The attendings performed 31 exams (62%) and the others performed 19 exams (38%). 72% of the exam surveys reported the ENLYT<sup>®</sup> flexible nasopharyngoscope was the same or easier to use than the SOC nasopharyngoscope. 88% of exams reported the ENLYT<sup>®</sup> video quality was \"the same\" to \"better\". 94% of exams reported the perceived patient pain with the ENLYT<sup>®</sup> flexible nasopharyngoscope was the same or less than the SOC nasopharyngoscope. Subjects reported that 88% of the exams were the same or less discomfort with the ENLYT<sup>®</sup> scope compared to the SOC scope.ConclusionThe portable ENLYT<sup>®</sup> flexible nasopharyngoscope was able to provide comparable exam results when compared to the SOC nasopharyngoscope.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251374480"},"PeriodicalIF":1.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969800","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}
Igor Monsellato, Teresa Gatto, Marco Palucci, Federico Sangiuolo, Mariantonietta Alagia, Fabio Giannone, Gianluca Cassese, Celeste Del Basso, Gabriela Del Angel-Millán, Fabrizio Panaro
{"title":"Optimized 'Full Right' Instrument Configuration in Robotic Rectal Surgery With the Da Vinci Xi System: A Prospective Single-Center Experience.","authors":"Igor Monsellato, Teresa Gatto, Marco Palucci, Federico Sangiuolo, Mariantonietta Alagia, Fabio Giannone, Gianluca Cassese, Celeste Del Basso, Gabriela Del Angel-Millán, Fabrizio Panaro","doi":"10.1177/15533506251374470","DOIUrl":"https://doi.org/10.1177/15533506251374470","url":null,"abstract":"<p><p>BackgroundRobotic surgery for rectal cancer offers enhanced visualization, instrument articulation, and ergonomic benefits in confined pelvic spaces. However, the effectiveness of robotic procedures depends heavily on trocar positioning and instrument layout. Conventional configurations often require intraoperative instrument swapping or camera repositioning, potentially disrupting workflow and increasing cognitive strain. To address these limitations, we implemented a standardized \"full right\" instrument configuration using the Da Vinci Xi system to improve ergonomic control and procedural stability.MethodsWe conducted a prospective analysis of 22 consecutive patients undergoing robotic rectal resection at a high-volume tertiary center using the full right configuration. All robotic arms and the assistant port were positioned along the patient's right side, with the camera fixed on Arm 2 throughout the procedure. Operative, perioperative, and pathological outcomes were evaluated.ResultsThe mean console time was 170 min, and the mean operative time was 192 min. No conversions or intraoperative complications occurred. No instrument collisions were observed. Estimated blood loss was minimal in all cases. The mean hospital stay was 5.2 days. All patients achieved complete (grade 3) mesorectal excision, with a mean lymph node yield of 16.4 and negative margins in every case. No major postoperative complications were reported.ConclusionsThe full right configuration for robotic rectal resection is associated with favorable short-term outcomes, improved ergonomic conditions, and stable instrument positioning. This layout supports consistent workflow across all operative phases and may reduce intraoperative cognitive load. Further validation through larger comparative studies is warranted.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251374470"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081593","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":"A Bibliometric Analysis on Application of Robot-Assisted Surgery in Plastic Surgery.","authors":"Jingyang Zhou, Xingyu Zhu, Runmeng Cui, Lin Lin","doi":"10.1177/15533506251372350","DOIUrl":"https://doi.org/10.1177/15533506251372350","url":null,"abstract":"<p><p><b>Background:</b> In recent years, robot-assisted surgery has been a major advancement in surgery and has gradually become the preferred approach. The precise operation, minimal invasiveness, and the ability to perform the preoperative planning are its characteristics. Due to the continuous improvements in plastic surgery technology over the past few decades, more researchers are trying to integrate robotic technology into plastic surgery. <b>Purpose:</b> This bibliometric study aims to quantatitively evaluate the published literature on the topic of robot-assisted plastic surgery indexed in the Web of Science Core Collection and provide a unique insight for subsequent researches in this field.<b>Research Design and Sample:</b> This time of bibliomteric analysis utilized data obtained fron the online database mentioned above and subsequent data analysis and visulization was abcieved by the R software. Totally 208 publications were enrolled after screening.<b>Data Collection and Analysis:</b> Further analysis on authors, sources, affiliations, trend topics, co-citation, keywords and thematic map was conducted on the bibliometric package.<b>Results:</b> The analysis mentioned above elucidates that the application of robot-assisted surgery in plastic surgery is prospering with a potential direction of \"flap\" and \"breast reconstrction\". <b>Conclusion:</b> Thedevelopment robot-assisted surgery encountered a continous surge in roughly a decade ago and will iterating with a promising future.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251372350"},"PeriodicalIF":1.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969773","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}
Shuai Liu, Yan Jiang, Xianyao Tao, Mingyu Xue, Li Qiang
{"title":"Three-Dimensional Computed Tomography Angiography Fusion Imaging for Posterior Interosseous Artery Perforator Location of Forearm Flap: A Retrospective Study of 23 Patients.","authors":"Shuai Liu, Yan Jiang, Xianyao Tao, Mingyu Xue, Li Qiang","doi":"10.1177/15533506251367265","DOIUrl":"https://doi.org/10.1177/15533506251367265","url":null,"abstract":"<p><p>BackgroundFlap surgery necessitates accurate identification of perforator locations for optimal outcomes. Color Doppler Sonography (CDS) has been a routine examination in preoperative planning, but its limitations in providing a comprehensive map of perforators relationships prompts exploration of alternative imaging modalities. This study introduces the application of a novel technique, three-dimensional computed tomography angiography fusion imaging (3D-CTA-FI), for precise interosseous artery perforator locating in forearm flap surgery.MethodA retrospective investigation including 23 patients receiving forearm flap surgery of posterior interosseous artery perforator was conducted, and two-phase computed tomography angiography (CTA) protocol was adopted in this study. Utilizing Mimics software, 3D models of vascular structures were meticulously reconstructed. Surgical procedures were guided by the 3D-CTA-FI, and accuracy of CDS and 3D-CTA-FI was evaluated by comparing visual and actual perforator positions.ResultsAll flaps were viable, and patients were discharged uneventfully. In our study, 3D-CTA-FI portrayed accurate depictions of vascular pedicles and perforators. The mean discrepancy between indicated and actual perforator positions was 2.9 ± 1.7 mm (Group 1) and 2.4 ± 1.7 mm (Group 2), accompanied by excellent consistency rates of 47.8% and 60.9%, respectively.ConclusionsThree-dimensional computed tomography angiography fusion imaging (3D-CTA-FI) provides detailed information of perforators in posterior interosseous artery perforator flap surgery, and its application in clinical practice is feasible and beneficial.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251367265"},"PeriodicalIF":1.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804900","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":"Shaping the Future of Surgical Procedures: A Bibliometric Analysis of Advanced Polymeric Surgical Materials Research in the Last Decade.","authors":"Wenhan Wu","doi":"10.1177/15533506251367251","DOIUrl":"https://doi.org/10.1177/15533506251367251","url":null,"abstract":"<p><p>AimThis study aims to systematically analyze the global research landscape of polymeric materials in surgical applications, identifying core themes, technological trends, and clinical translation potential over the past decade.MethodsA bibliometric analysis was conducted using the Web of Science Core Collection (2016-2025). A targeted search strategy combining polymer-related, surgery-related, and functional biomedical keywords was applied. Data were analyzed using the Bibliometrix R package and VOSviewer to explore publication trends, international collaborations, keyword co-occurrence, and citation networks. Key studies were manually reviewed to interpret their technological contributions.ResultsA total of 4668 original articles were retrieved, showing a 15.8% annual growth. China led global output (49.9%), followed by the USA. Keyword clustering revealed four major themes: nanoparticle-based drug delivery, biological responses and angiogenesis, clinical surgical applications (eg, hemostasis, adhesion), and multifunctional hydrogels. Research hotspots included antibacterial, adhesive, and hemostatic materials. Highly cited studies focused on injectable, self-healing, and bioactive hydrogels for complex wound repair and organ-specific applications.ConclusionThe field of surgical polymeric materials is rapidly advancing toward multifunctional, minimally invasive, and responsive systems. This bibliometric study provides a data-driven knowledge map to guide future research and promote clinical translation, helping bridge the gap between material innovation and surgical application. Future research should also focus on optimizing the scalability and cost-effectiveness of these technologies while addressing regulatory and safety challenges. Large-scale clinical trials and interdisciplinary education help bridge the gap between materials science and clinical implementation.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251367251"},"PeriodicalIF":1.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795541","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 : 2025-08-01Epub Date: 2025-04-18DOI: 10.1177/15533506251328479
Tarek Hassab, Margaret Turlington, Stephen M Kavic
{"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}
Surgical InnovationPub Date : 2025-08-01Epub Date: 2025-05-01DOI: 10.1177/15533506251339931
Dimitra V Peristeri, Sai Sandeep Singh Rowdhwal
{"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/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":"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}