Surgical Innovation最新文献

{"title":"Mixed Reality for Localisation of Rib Fractures Before Surgical Stabilization: A Pilot Study of an Innovative Tool.","authors":"Jineel H Raythatha, Alireza Moghadam, Hoijoon Jung, Ge Jin, Jinman Kim, Jeremy Hsu","doi":"10.1177/15533506251393422","DOIUrl":"10.1177/15533506251393422","url":null,"abstract":"<p><p>BackgroundAccurate localisation of rib fractures is crucial for successful surgical stabilisation of rib fractures (SSRF). Mixed reality (MR) technology can overlay anatomical imaging onto a patient in real-time, which may facilitate the visualisation of rib fractures, allowing accurate skin surface markings for incision. This pilot study assessed the feasibility of using mixed reality (MR) for rib fracture localisation in SSRF.MethodsThis study involved a pre-clinical phase with two healthy patients and a clinical phase with six patients undergoing SSRF in a single tertiary trauma centre. CT scans were transformed into patient-specific 3D holographic models, which were projected through Microsoft HoloLens2TM (HL2) onto the patient after anatomical calibration. The study assessed hologram projection, number of fractures identified, time taken, and distance from skin marking to the fracture site. Iterative improvements to the MR system were implemented throughout the study.ResultsStable and accurate hologram projection was achieved in both phases. In the clinical portion, MR identified 54 rib fractures, including subscapular fractures, compared to 30 identified by US. The mean time to mark all fractures was 9.07 minutes for MR and 10.02 minutes for US. The mean displacement from skin marking to the fracture site was 2.89 cm for MR and 2.04 cm for US. Technical challenges included distorted surface anatomy and positional variations.ConclusionMR technology in the setting of SSRF is feasible and facilitates de-novo visualisation of rib fractures. Technical limitations must be addressed before widespread clinical use.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"150-157"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453154","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: \"Early Experience With a Novel Super-Hydrophilic Laparoscopic Scope Cleaning Device and Narrative Review of Available Cleaning Strategies\".","authors":"Nabil Mohammad Azmi, Diana Melissa Dualim, Zairul Azwan Mohd Azman, Ismail Sagap","doi":"10.1177/15533506251392449","DOIUrl":"10.1177/15533506251392449","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"196-197"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393338","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":"From Laparoscopy to Robotics: Navigating the Learning Curve in Colon Cancer Surgery Within a High-Volume East London District General Hospital.","authors":"Valentin Butnari, Jatinder Hayre, Olivia Pestrin, Ahmer Mansuri, Sandeep Kaul, Richard Boulton, Joseph Huang, Nirooshun Rajendran","doi":"10.1177/15533506251392433","DOIUrl":"10.1177/15533506251392433","url":null,"abstract":"<p><p>BackgroundRobotic-assisted surgery (RAS) is widely adopted, and understanding the learning curve (LC) is crucial for surgeons self-assessment and credentialling. We characterised the transition from laparoscopy to robotic approach for three experienced surgeons based on analysis of colectomies performed for malignancy.MethodsWe analysed retrospectively all consecutive robotic colon cancer surgeries performed between February 2020 and April 2025. We excluded rectal cancer resections, palliative, multivisceral and beyond TME cases. The cumulative summation (CUSUM) methodology was utilised to graphically represent the colectomy LC based on total operative time.ResultsOur analysis included 184 colectomies: 75 performed by surgeon 1, 65 by surgeon 2, and 44 by surgeon 3. Demographics data and tumour characteristics were comparable between surgeons, exempt from operative time and previous abdomino-pelvic surgery (<i>P</i> < .05). The CUSUM curve revealed a three-phase pattern: a learning phase (cases 1-16), a competence phase (cases 17-29), and a proficiency phase (beyond case 30). The median total operative time trended downward from the learning phase (240 min) to the proficiency phase (218 min), though this was not statistically significant (<i>P</i> = .13). We also observed a trend towards reduced estimated blood loss (109 mL to 86 mL, <i>P</i> = .066) and a decrease in 30-day re-admission rates from 14% to 4% (<i>P</i> = .11) in the proficiency phase.ConclusionWe present our department LC with the DaVinci Xi Robot for surgical treatment of colonic cancer. Based on our calculations, it is necessary for a surgeon to perform 30 robotic cases to reach the proficiency part of the LC of RAS for colonic resections.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"100-109"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393295","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 Ergonomics: Where Do We Stand?","authors":"Sampath Gnanarathne, Chandima Rathnayake","doi":"10.1177/15533506251396685","DOIUrl":"10.1177/15533506251396685","url":null,"abstract":"<p><p>BackgroundLaparoscopic surgery has become widely accepted in gynecological practice due to its clinical benefits for patients. However, it introduces significant ergonomic challenges for surgeons, often resulting in musculoskeletal discomfort and occupational injury.ObjectiveThis study aims to assess the level of knowledge on ergonomic principles among postgraduate trainees in obstetrics and gynecology, and to highlight the necessity of formal ergonomic training to prevent work-related injuries.MethodsA structured questionnaire was distributed among postgraduate trainees of post graduate institute of Medicine, Sri Lanka. Data on surgical experience, training background, ergonomic awareness, and prevalence of physical discomfort were collected and analyzed.Results40 post graduate trainees participated in the survey. A significant proportion of trainees demonstrated limited awareness of fundamental ergonomic concepts. The mean knowledge score was as low as 25.00 ± 21.36. The majority reported musculoskeletal symptoms during or after laparoscopic surgery. Knowlegde score was not significantly correlated with discomfort severity (Spearman's ρ = -0.212,<i>P</i> = 0.190), indicating that ergonomic knowledge alone may not mitigate musculoskeletal strain.ConclusionThe findings underscore the urgent need for formal ergonomic education and the implementation of ergonomic guidelines in surgical training to improve surgeon well-being and operating efficiency.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"181-185"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446045","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":"Can Artificial Intelligence Revolutionise Surgical Decision-Making for Appendectomy? A Narrative Review.","authors":"Ali Murtada, Marco David Bokobza De la Rosa, Fatima Kayali, Albert Mensah, Shuaiyb Majid, Samuel N S Ghattas, Samuel S S Rezk, Ian Williams, Damian M Bailey, Matti Jubouri, Mohamad Bashir","doi":"10.1177/15533506251393123","DOIUrl":"10.1177/15533506251393123","url":null,"abstract":"<p><p>IntroductionAcute appendicitis is a common cause of acute abdomen in secondary care. Despite advancements in diagnostics, misdiagnosis and negative appendectomies remain significant. Artificial Intelligence (AI), particularly machine learning (ML) and deep learning, shows promise in improving diagnostic accuracy.Materials and MethodsA literature review using PubMed and Cochrane databases included studies on AI's role in diagnosing and prognosing appendicitis. Studies relying solely on clinical or radiology reports were excluded.ResultsAI models, particularly random forest (RF), logistic regression (LR), and neural networks (NN), demonstrated high diagnostic accuracy, with RF outperforming others. Machine learning methods like SVM and XGBoost (XGB) were effective in predicting appendicitis prognosis, especially in distinguishing complicated cases. AI models outperformed traditional diagnostic scores, such as the Alvarado score.ConclusionAI has significant potential to enhance the diagnosis and prognosis of acute appendicitis, but challenges in data requirements and standardisation must be addressed for widespread clinical use.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"138-149"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393284","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":"Comparative Study of the Muyo Hook Technique and Conventional Methods for Primary Trocar Insertion in Laparoscopic Surgery.","authors":"Sagiran Sagiran, Azzam Hizbur Rahman","doi":"10.1177/15533506251381975","DOIUrl":"10.1177/15533506251381975","url":null,"abstract":"<p><p>BackgroundThe Veress needle and open (Hasson) approach are common methods for creating pneumoperitoneum in laparoscopic surgery. However, these techniques can be time-consuming and carry the risk of organ or blood vessel injury. The Muyo Hook offers a new approach that allows direct trocar insertion without needing prior pneumoperitoneum. This study compares its effectiveness and evaluates perioperative outcomes with conventional methods in laparoscopic appendectomy and cholecystectomy.Materials and MethodsA comparative study was conducted at Nur Hidayah Hospital from April to August with 40 patients divided into 3 groups: Group A (Muyo Hook, 16 patients), Group B (Veress needle, 14 patients), and Group C (Muyo Hook without Veress, 10 patients). The study measured the time from skin incision to Veress insertion (Groups A and B) and the time for the first trocar insertion. Safety outcomes were also assessed, including organ or vessel injury, hematomas, and pain.ResultsThe Muyo Hook achieved pneumoperitoneum in an average of 18.05 seconds (range: 3.58-39.5 seconds), much faster than the conventional method (95.96 seconds; <i>P</i> < 0.05). Group C (Muyo Hook without Veress) had the quickest times. No complications were reported, such as organ or vessel injuries, skin hematomas, or pain.ConclusionWithin the limitations of this study, the Muyo Hook technique appeared efficient, practical, and cost-effective. No complications were observed in this small cohort; however, larger prospective studies are required before drawing definitive conclusions regarding its safety. The device may simplify the procedure, reduce operative time, and enhance practicality for minimally invasive surgery.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"89-95"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145178662","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":"Ray-Ban Meta: A Ray of Hope in the Operating Room (and Beyond).","authors":"Lucian M Feraru, David C Klonoff, David G Armstrong","doi":"10.1177/15533506251383696","DOIUrl":"10.1177/15533506251383696","url":null,"abstract":"<p><p>BackgroundWearable smart glasses offer new opportunities to enhance limb preservation surgery by enabling hands-free photo/video capture, real-time communication, and improved surgical education. While earlier devices such as Google Glass demonstrated feasibility, they were hindered by limited battery life and cumbersome ergonomics. The new Ray-Ban Meta smart glasses may address these limitations by providing high-definition recording in a lightweight, ergonomic frame. Recent consumer-grade smart glasses may address these limitations by providing high-definition recording in lightweight, ergonomic frames.MethodsFrom November 2023 to April 2025, 2 limb preservation surgeons used Ray-Ban Meta consumer-grade smart glasses during foot and ankle procedures. Five domains were evaluated: overall use and feasibility, image and video utility, workflow and communication impact, team and trainee feedback, and technical performance. Patients were enrolled based on procedural scheduling and availability for device setup, with written consent obtained preoperatively.ResultsThe smart glasses were easily integrated into operative workflows, enabling hands-free documentation without disrupting sterility. Trainees found first-person footage more engaging than conventional video formats. Real-time streaming supported remote consultation, and occasional live transmission facilitated tele-mentoring. Although battery capacity decreased with frequent use, no major technical failures occurred over the study period.ConclusionThis is the first comprehensive report on using Ray-Ban Meta consumer-grade smart glasses in limb preservation surgery. Early findings support their use as a low-profile, hands-free solution for intraoperative documentation, education, and communication. Further optimization-especially regarding battery endurance and data integration-will enhance the role of wearable devices in surgical care.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"110-114"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226024","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":"Fast Track Pathway for Lung Cancer: The Integration of ION Robotic-Assisted Bronchoscopy With Robotic Thoracic Surgical Resection.","authors":"Juliana Guarize, Luca Bertolaccini, Lorenzo Spaggiari","doi":"10.1177/15533506251375786","DOIUrl":"10.1177/15533506251375786","url":null,"abstract":"<p><p>BackgroundDelays between diagnosis and definitive treatment in early-stage lung cancer can lead to disease progression and patient anxiety. Recent advances in robotic-assisted bronchoscopy and surgery provide opportunities to streamline care and reduce treatment timelines.To evaluate the feasibility, safety, and diagnostic performance of an integrated Fast Track protocol combining ION robotic-assisted bronchoscopy with radioactive marker placement and subsequent robotic surgical resection in patients with small or indeterminate pulmonary nodules.MethodsA retrospective cohort study was conducted on consecutive patients undergoing ION-guided bronchoscopy with technetium-99m-labeled marker placement, followed by robotic resection, from December 1, 2024, to March 31, 2025. The protocol included preoperative imaging (Day 1), bronchoscopy with biopsy and marker placement (Day 2), and robotic surgery (Day 3). Primary outcomes included diagnostic yield and need for preliminary wedge resection; secondary outcomes assessed localization accuracy, perioperative results, and procedural complications.ResultsTen patients were included, with a median age of 59 years and a median nodule diameter of 14.0 mm. Diagnostic yield from bronchoscopy was 90%, and localization success was 100%. Robotic resection (lobectomy in 9 cases, segmentectomy in 1) was performed the day after bronchoscopy. No procedural complications occurred, and the median hospital stay was six days.ConclusionsThis integrated Fast Track pathway is feasible, safe, and effective in expediting diagnosis and treatment for early-stage lung cancer. However, the small sample size of this initial series (n = 10) limits the generalizability of these findings, which should be interpreted in the context of our institutional case selection, favoring nodules accessible by the ION system and patients with good performance status. The protocol enhances clinical efficiency by consolidating diagnostic and therapeutic steps while maintaining high diagnostic accuracy. Broader validation is warranted in larger multicenter studies.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"96-99"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490196","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":"Efficacy of Moth-Eye Technology in Preventing Surgical Loupe Lens Fogging.","authors":"Shinji Tanishima, Katsunori Kimura, Masaru Ueki, Atsuro Koga, Kazutake Uehara, Naofumi Saiki, Hideki Nagashima","doi":"10.1177/15533506261438187","DOIUrl":"https://doi.org/10.1177/15533506261438187","url":null,"abstract":"<p><p>Background/NeedSurgical loupe fogging caused by exhaled humid air significantly impairs operative visibility and precision. Existing surfactant-based antifogging agents provide only temporary effects and require repeated application.Methodology and Device DescriptionMoth-eye nanostructure technology was applied to the optical surface using a transparent processed film. The nanoscale pillar array induces superhydrophilicity through a purely physical mechanism, allowing condensed moisture to spread uniformly rather than forming light-scattering droplets.Preliminary ResultsUnder high-humidity conditions, untreated lenses showed marked loss of visual clarity. In contrast, moth-eye-processed lenses consistently preserved transparency, as supported by objective image-based \"color count\" assessment.Current StatusThis technology remains at the proof-of-concept stage and is not commercially available. Ongoing development focuses on direct nanoimprinting onto medical-grade optical devices and evaluation of long-term durability and clinical usability.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261438187"},"PeriodicalIF":1.6,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522067","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":"An Array of Factors Influence Robotics Adoption in Lower Urinary Tract Reconstruction.","authors":"Katerina Lembrikova, George E Aninwene, Peyton Tebon, Savannah Starr, Matthew Becker, Allen Siapno, Justine Yamashiro, Erika Wood, Eduardo Piqueiras, Kristen Williams, Renea M Sturm","doi":"10.1177/15533506261439183","DOIUrl":"https://doi.org/10.1177/15533506261439183","url":null,"abstract":"<p><p>IntroductionUrology has been a leader in the adoption of robotic technologies, with robotic prostatectomies far surpassing an open approach in the United States. However, this widespread adoption has not extended to lower urinary tract reconstruction (LUTR) such as neobladder creation and bladder augmentation. This study aims to identify factors that influence robotics adoption in these procedures from the perspectives of a wide range of stakeholders.MethodsSemi-structured, qualitative interviews were conducted as part of the National Science Foundation Innovation Corps (NSF I-Corps) entrepreneurship program. Analysis of transcribed notes was completed by six reviewers using a modified framework method. Each theme and subtheme was categorized as a driver or barrier to robotics adoption, and the strength of each factor was calculated via skew (the sum of the rating values divided by the total number of instances it was mentioned).ResultsOf 101 interviews, 84 discussed robotics in lower urinary tract reconstruction comprising 28 urologists, 16 device representatives, 22 administrators, 7 patients, 5 researchers, and 6 referring physicians. 21 subthemes were identified across 5 major themes. The three primary drivers of adoption of robotics were outcomes, competition across hospital systems, and complications, while the top three barriers were patient factors/comorbidities, perceived learning curve, and operative time.DiscussionWhile understanding traditional outcome measures remains critical, market dynamics, training requirements, and procedural challenges are additional core elements that affect robotics adoption in LUTR. Addressing these barriers through early training, advancements in device development (eg, reducing anastomotic complexity), and enhanced institutional support models (eg, OR time, dedicated robotic staff) to optimize operative availability can accelerate impactful innovation and integration of robotics into LUTR.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261439183"},"PeriodicalIF":1.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147522032","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}