Surgical Innovation最新文献

{"title":"An Umbrella Review of Systematic Reviews Evaluating Learning Curves for Surgical Procedures.","authors":"Jozel Ramirez, Matthew Kobetic, Toby Leach, Christin Hoffmann, Natalie S Blencowe","doi":"10.1177/15533506261472735","DOIUrl":"https://doi.org/10.1177/15533506261472735","url":null,"abstract":"<p><p>The surgical learning curve is a critical component of surgical innovation. However, currently there is no standardised way to report or measure it. This umbrella review aims to identify and synthesise the terminology, data items, and methods used to define, describe and illustrate the learning curves for surgical procedures.MethodsAn umbrella review of systematic and scoping reviews was conducted using searches in Ovid MEDLINE, Embase, Cochrane Library, and Epistemonikos from January 2010 to January 2023. Eligible reviews examined the learning curve of a procedure, technique, or device. Data extracted included review characteristics, terminology and definitions, surgeons' learning experience, and data items used to measure the learning curve. Methodological quality was assessed using AMSTAR-2.ResultsSixty-two reviews were included, covering 1990 unique studies. A definition of the learning curve was provided in 39 reviews (63%). Sixteen additional related terms (eg, proficiency, competency, plateau) were identified, though definitions were often not provided. Surgeons' expertise was reported in 39 reviews (63%), with 19 (31%) specifying training grades. Across all reviews, 712 unique data items were identified, most commonly intra-operative metrics (n = 336, 47%), of which 42% were time-related (n = 142). Most reviews were rated as low (n = 15) or critically low (n = 45) quality.ConclusionOverall, there is substantial variability in definitions, terminology, and data items used to describe the surgical learning curve. This heterogeneity limits evidence synthesis and complicates identification of meaningful measures. The identified data items will support development of a core data set for describing and measuring learning curves for surgical procedures.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261472735"},"PeriodicalIF":2.2,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621449","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":"First Reported Ivor Lewis Esophagectomy Using the HUGO RAS System in a High-Volume Center: A Technical Feasibility Report and Configurational Setup.","authors":"Julia Umstadt, Jan-Niklas Hochstein, Margret Alm, Jan-Hendrik Egberts","doi":"10.1177/15533506261474216","DOIUrl":"https://doi.org/10.1177/15533506261474216","url":null,"abstract":"<p><p>BackgroundRobot-assisted minimally invasive esophagectomy (RAMIE) has become an increasingly utilized approach in the surgical treatment of esophageal cancer. However, widespread use of robotic systems remains limited by high costs and restricted platform availability. The HUGO RAS system represents a novel modular platform with limited data in esophageal surgery.MethodsThis report describes the technical implementation and operative workflow of a robot-assisted Ivor Lewis esophagectomy using the HUGO RAS system. The procedure was performed in a standardized two-stage approach, including an abdominal and thoracic phase. Emphasis was placed on port placement, docking configuration, arm positioning and intraoperative instrument management. Key steps of esophageal mobilization, lymphadenectomy and intrathoracic anastomosis are detailed to illustrate the integration of the system into a complex two-cavity procedure.ResultsThe operation was completed without intraoperative complications or conversion. The described setup provided stable access to both cavities and enabled precise dissection and reconstruction. Oncologic resection achieved negative margins (R0) and 23 lymph nodes were harvested (ypT3 ypN2). The postoperative course was complicated by atrial arrhythmia and pneumonia, both managed successfully. No anastomotic complications occurred and oral intake was resumed without difficulty.ConclusionThis report demonstrates the feasibility of robot-assisted Ivor Lewis esophagectomy using the HUGO RAS system and provides a structured framework for its implementation in complex two-cavity procedures. Its modular design allows flexible docking strategies and a safe operative workflow. These findings may support further adoption of this novel robotic platform in upper gastrointestinal surgery.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261474216"},"PeriodicalIF":2.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607736","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":"One-Year Outcomes of Sleeve-Dor Fundoplication for Obesity and Gastroesophageal Reflux Disease.","authors":"Waseem Hariri, Ricardo Zorron, Frank Marusch, Wael Eskander","doi":"10.1177/15533506261470732","DOIUrl":"https://doi.org/10.1177/15533506261470732","url":null,"abstract":"<p><p>Recent literature has highlighted an increased risk of de novo gastroesophageal reflux disease (GERD) and a higher incidence of Barrett's esophagus following sleeve gastrectomy (SG), raising concerns regarding the potential development of esophageal adenocarcinoma in this population. This study evaluates the Sleeve-Dor procedure, a modification of SG that incorporates an anterior 180° Dor fundoplication, as a protective strategy against these long-term complications in patients with obesity. A standard SG was performed laparoscopically, leaving a small redundancy of the gastric fundus to create a 180° anterior wrap anchored to the right crus without dissecting the hiatus. This configuration provides partial fundoplication designed to prevent or alleviate reflux symptoms following SG. Ethical approval for data collection and analysis was obtained in accordance with the Declaration of Helsinki, and all patients provided informed consent. The Sleeve-Dor procedure demonstrated a favorable safety profile, effective reflux control, and satisfactory weight-loss outcomes over the follow-up period, with low morbidity and no increase in perioperative complications compared with conventional SG. These findings suggest that the Sleeve-Dor approach may represent a valuable surgical option for patients with obesity and pre-existing or potential reflux disease. By integrating a physiological anti-reflux mechanism into the SG framework, this technique may reduce the risk of postoperative GERD and Barrett's esophagus without compromising bariatric efficacy.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261470732"},"PeriodicalIF":2.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148607841","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":"LappClinic: Unveiling the Impact of Residents' Surgical Video Analysis and Simulation Training on Skill Development in Laparoscopic Cholecystectomy - A National Multi-Center Study.","authors":"Diego Sanhueza R, Cristian Jarry T, Maria Elena Vial B, Sofia Abedrapo L, Enrique Cruz M, Matías Aguilera, Gabriel Escalona, Felipe Silva, Martin Inzunza, Caterina Contreras, Javier Vela, Julian Varas C","doi":"10.1177/15533506261471416","DOIUrl":"https://doi.org/10.1177/15533506261471416","url":null,"abstract":"<p><p>BackgroundQuality feedback is essential to surgical learning. Simulation training accelerates skill acquisition, and video-based assessment (VBA) offers proven educational benefits. However, evidence of their combined effect in real surgical cases is limited. We conducted a multi-center intervention integrating VBA and remote-asynchronous feedback for real laparoscopic cholecystectomies (LC) and the completion of an Advanced Laparoscopy Course (ALC). Users experience, and an analysis of objective performance outcomes was performed.MethodsSeven general-surgery residency programs in Chile participated (2022-2025). Residents uploaded LC videos to the LAPPCLINIC platform and were randomized to receive either assessment-only or assessment + asynchronous expert feedback. Perceptions were evaluated through an online survey and focus group. Videos were assessed using OSATS and OPRS. ALC status was registered. The primary outcome was achievement of OSATS ≥20. Mixed-effects logistic regression adjusted for ALC status, feedback arm, cumulative case number, and surgical difficulty.ResultsOf 142 invited residents, 51 (35.9%) participated, uploading 455 videos (436 eligible). Twenty-eight residents completed the survey: 96% desired additional feedback beyond the OR. Platform feedback was rated higher than OR feedback (6.2 vs 5.25/7, <i>P</i> = .0065). ALC completion was independently associated with higher odds of OSATS ≥20 (OR 4.69; 95% CI 1.53-14.4; <i>P</i> = .0069). Feedback allocation was not significant (OR 0.40; 95% CI 0.15-1.08; <i>P</i> = .070).ConclusionsResidents rated asynchronous feedback higher than conventional OR feedback. Completion of the ALC correlated with objectively higher surgical performance, supporting the integration of structured simulation and video-based coaching within residency curricula.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261471416"},"PeriodicalIF":2.2,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Dogan Technique for Lower Inner Quadrant Breast Tumors: A Novel Volume Displacement Oncoplastic Approach.","authors":"Lütfi Doğan, Yunus Emre Bölükoğlu, Mehmet Furkan Sağdıç, Mahmut Onur Kültüroğlu","doi":"10.1177/15533506261469959","DOIUrl":"https://doi.org/10.1177/15533506261469959","url":null,"abstract":"<p><p>BackgroundBreast tumors located in the lower inner quadrant remain challenging in oncoplastic surgery due to limited tissue volume and the risk of unsatisfactory cosmetic outcomes. This study describes a surgical technique developed to address these challenges while maintaining oncologic principles.MethodsA retrospective descriptive analysis was performed on 5 consecutive patients with lower inner quadrant breast tumors who underwent breast-conserving surgery between January 2025 and March 2026 using this technique. The approach is based on a triangular design, mobilization of a superior glandular flap, and placement of the incision within the inframammary fold without manipulation of the nipple-areola complex.ResultsThe planned surgical design was achieved in all cases. Negative surgical margins were obtained in all patients. No major postoperative complications, including wound complications or nipple-areola complex ischemia, were observed. Early postoperative assessment demonstrated satisfactory breast contour and symmetry.ConclusionThis technique may be considered a feasible option for selected patients with lower inner quadrant tumors. The initial findings suggest favorable early oncologic and aesthetic outcomes. Further studies with larger cohorts and longer follow-up are needed to confirm these results.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261469959"},"PeriodicalIF":2.2,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412867","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 Application of a Modified Ureteral Stent Placement Technique in Ureteroscopy.","authors":"Huan Cheng, Zijin Wan, Jingyang Liang, Haosen Lu, Yue Zhou, Lijun Mao","doi":"10.1177/15533506261462064","DOIUrl":"https://doi.org/10.1177/15533506261462064","url":null,"abstract":"<p><p>ObjectiveThis study is conducted to evaluate the clinical value of a modified ureteral stent placement technique in patients undergoing ureteroscopic surgery.MethodsA total of 138 patients with renal or ureteral calculi were randomized to receive either conventional or modified ureteral stent placement following ureteroscopic lithotripsy (69 per group). The primary outcome was the duration of postoperative hematuria, and the secondary outcomes included operative time, hospital stay, White blood cell count (WBC) and procalcitonin (PCT) levels, Ureteral Stent Symptom Questionnaire (USSQ), Generic Quality of Life Inventory-74 (GQOLI-74), stone clearance rate, postoperative complications, and 30-day readmission rates.ResultsCompared with the conventional group, the modified group had shorter hematuria duration, lower WBC and PCT levels at 2 weeks, lower USSQ scores for urinary symptoms, physical pain, and sexual life at 2 weeks, and higher GQOLI-74 scores for physical, psychological, and social function at 6 weeks (all <i>P</i> < .05). Operative time, hospital stay, stone clearance rate, and complication and readmission rates were similar between groups (all <i>P</i> > .05).ConclusionThe modified ureteral stent technique alleviates postoperative hematuria and stent-related symptoms, reduces early inflammatory responses, and improves quality of life without increasing adverse outcomes.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261462064"},"PeriodicalIF":2.2,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382851","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":"Vibe Coding in Neurosurgery: Bridging the Gap Between Clinical Needs and Digital Innovation-A Narrative Review and Practical Perspective.","authors":"Muhammed Yusuf Hamurcu","doi":"10.1177/15533506261467669","DOIUrl":"https://doi.org/10.1177/15533506261467669","url":null,"abstract":"<p><p>BackgroundArtificial intelligence (AI) and machine learning are transforming neurosurgical research and practice, yet the programming barrier has excluded most clinicians from building customized digital tools. Vibe coding - generating functional software through natural language instructions to large language models - has substantially lowered this barrier since its formalization in 2025. No study has examined its applications specifically within neurosurgery.MethodsA narrative review of the literature was conducted using PubMed, Google Scholar, and preprint repositories through April 2026, supplemented by the author's direct clinical experience developing vibe-coded tools in a tertiary neurosurgical unit.FindingsExisting literature on vibe coding in medicine is sparse and limited to non-surgical specialties; no prior publication addresses it in a neurosurgical context. Three practical domains of application are identified: (1) research data collection and multi-scale patient classification, illustrated by a personally developed integrated scoring tool for aneurysmal subarachnoid hemorrhage (Figure 1); (2) clinical workflow optimization including documentation and follow-up automation; and (3) educational tool development and literature engagement.ConclusionVibe coding represents an accessible paradigm enabling neurosurgical trainees to develop purpose-specific digital tools without programming expertise. The field lacks specialty-specific guidance on this approach. This review aims to address that gap and encourage adoption of vibe coding as a practical complement to institutional digital health infrastructure.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261467669"},"PeriodicalIF":2.2,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148369941","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":"Screw-Lock: A Novel Technique to Secure Burr Hole Base Ring in DBS Surgery.","authors":"Pawan Kumar Verma, Subhajit Das, Milind Deogaonkar","doi":"10.1177/15533506261462815","DOIUrl":"https://doi.org/10.1177/15533506261462815","url":null,"abstract":"<p><p>NeedDuring deep brain stimulation (DBS) surgery, the base ring of the burr hole is the main structure that anchors the DBS lead. A discrepancy between the burr hole size and ring base renders the ring unstable which in turn compromises lead stability. Burr hole size mismatch is often seen in resource-poor countries where advanced perforators, that make exact size holes are not available.Technical SolutionWe describe a simple, cost-effective technique, the <i>screw-lock</i> method. When there is a mismatch, titanium self-tapping screws are inserted through the holding holes of the base ring into the skull with immediate and stable fixation.Proof of ConceptThis technique not only immediately secures the base ring to the skull but also prevents accidental displacement of the DBS lead.Next StepsThe titanium screws can be included in the burr hole ring set in commercially available products. A new type of expandable burr hole rings can be designed to fit any size of burr hole.ConclusionThis is an effective method to stabilize the burr hole base ring and the DBS lead.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261462815"},"PeriodicalIF":1.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253267","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":"Preliminary in Vitro Study on an RFID-Tagged Gauze Detection System to Prevent Retention During Laparoscopic Procedures.","authors":"Jae Kyun Park, Hwan Yi Joo, Dae Hwan Kim, Tae Yong Jeon, Seokyoung Ahn, Chang-In Choi","doi":"10.1177/15533506261462072","DOIUrl":"https://doi.org/10.1177/15533506261462072","url":null,"abstract":"<p><p>BackgroundRetained surgical items (RSIs) represent a significant patient safety concern in minimally invasive surgery (MIS) due to the limitations of conventional detection methods. This study evaluated the technical feasibility of a novel triple-detector radiofrequency identification (RFID) system integrated into a laparoscopic port for automated, real-time tracking and directional differentiation of surgical gauze during procedures.MethodsWe developed a prototype system integrating three RFID detectors (134.2 kHz) longitudinally into a standard 12-mm laparoscopic port. In a controlled laboratory setting, 118 pieces of RFID-tagged gauze were systematically inserted and retrieved through the port, generating 236 events. The study evaluated detection accuracy across outer, middle, and inner channels, alongside directional discrimination capability and temporal tracking performance using a laparoscopic training model.ResultsDetection rates exceeded 99% across all three channels (99.58% for the outer channel and 99.15% for middle and inner channels). Directional differentiation accuracy, based on sequential detection patterns, was 94.92% for insertion and 95.76% for removal. Anomalous patterns (4-5%), such as channel omission or duplicate detection, were observed due to passage speed or angle, but they did not impact the final determination of gauze presence or absence.ConclusionsThis proof-of-concept study demonstrates that an RFID-integrated laparoscopic port can achieve high detection (>99%) and directional accuracy (∼95%). These findings support its technical feasibility as an automated safety mechanism for potentially reducing the risk of RSIs in laparoscopic surgery; however, further validation through animal studies and clinical trials is required to confirm these results.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261462072"},"PeriodicalIF":1.6,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148253288","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 Vs Open Ladd's Procedure for Intestinal Malrotation in Infants and Children: A Systematic Review and Meta-Analysis.","authors":"Yan Lang, Qian Chen, Mengyu Wu, Guo Chen, Wenyuan Liu, Chen Yuan","doi":"10.1177/15533506261460156","DOIUrl":"https://doi.org/10.1177/15533506261460156","url":null,"abstract":"<p><p>PurposeThis study aimed to compare the outcomes of laparoscopic Ladd's procedure (LL) and open Ladd's procedure (OL) for the treatment of intestinal malrotation in infants and children, focusing on operative parameters, postoperative recovery, and complications through a systematic review and meta-analysis.MethodsA comprehensive literature search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted up to June 2025 following PRISMA guidelines. Studies comparing LL and OL in pediatric patients (<18 years) were included. Data were analyzed using Review Manager 5.4. Mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using fixed- or random-effects models depending on heterogeneity.ResultsEighteen studies including 3479 patients (LL: 928; OL: 2551) met the inclusion criteria. There was no significant difference in operative time between LL and OL (MD = 9.14, 95% CI: -4.01-22.28; <i>P</i> = 0.17). However, LL showed shorter time to full intake (MD = -2.64 days; <i>P</i> < 0.001) and shorter hospital stay (MD = -3.19 days; <i>P</i> < 0.001). LL was associated with lower rates of adhesive bowel obstruction (OR = 0.44; <i>P</i> < 0.001) and overall complications (OR = 0.39; <i>P</i> < 0.001), but higher rates of postoperative volvulus (OR = 3.26; <i>P</i> = 0.002) and reoperation (OR = 1.67; <i>P</i> = 0.03).ConclusionsLaparoscopic Ladd's procedure offers advantages in postoperative recovery and reduced complication rates compared with the open approach, though it may carry a higher risk of volvulus and reoperation.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261460156"},"PeriodicalIF":1.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212534","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}