Surgical Innovation最新文献

{"title":"Feasibility of Three-Dimensional Imaging in Accurately Assessing the Peritoneal Cancer Index for Peritoneal Carcinomatosis.","authors":"Eduardo Diaz, Emilio Vicente, Yolanda Quijano, Hipolito Duran, Isabel Fabra, Luis Malave, Pablo Ruiz, Gabriel Garabote, Luca Ballelli, Alessandro Broglio, Gianvito Varvaro, Alessandro Sirotti, Lina García Cañamaque, Laura Arrieta Larraz, Riccardo Caruso, Valentina Ferri","doi":"10.1177/15533506261454933","DOIUrl":"https://doi.org/10.1177/15533506261454933","url":null,"abstract":"<p><p>BackgroundAccurate preoperative staging of peritoneal carcinomatosis (PC) is crucial for planning cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). However, conventional imaging often underestimates disease burden. This study evaluated whether three-dimensional (3D) reconstruction based on multimodality imaging improves estimation of the peritoneal cancer index (PCI) compared with CT.MethodsWe conducted a retrospective analysis of patients with PC undergoing CRS-HIPEC between February 2022 and February 2025. Preoperative imaging included contrast-enhanced CT and multimodality-based 3D reconstruction (CT, MRI, PET). Imaging-derived PCI (CT-PCI and 3D-PCI) was compared with surgical PCI (reference standard). The primary endpoint was the signed difference (PCI_ref - PCI_index). Agreement was assessed using Bland-Altman analysis. Region-level diagnostic performance (sensitivity, specificity, PPV, NPV) was evaluated.ResultsAmong 62 patients undergoing 3D reconstruction, 42 were included in the final analysis. The median signed difference between imaging and surgical PCI was lower for 3D than for CT (2.0 vs 3.0), although not statistically significant (<i>P</i> = 0.101). Bland-Altman analysis showed a slightly lower mean bias for 3D compared with CT (+5.3 vs +6.2), indicating a tendency toward underestimation by both modalities. Region-level analysis demonstrated high specificity (>90%) but limited sensitivity, particularly in anatomically challenging areas such as the mesenteric root and small-bowel serosa.ConclusionsMultimodality-based 3D reconstruction may improve PCI estimation compared with CT alone, although differences were not statistically significant. Both approaches showed limited sensitivity in critical regions. These findings are exploratory and highlight the need for prospective validation.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261454933"},"PeriodicalIF":1.6,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148212567","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 Future of Hernia Surgery: Innovation, Integration, and Individualization.","authors":"Jacob Rosenberg","doi":"10.1177/15533506261459220","DOIUrl":"https://doi.org/10.1177/15533506261459220","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261459220"},"PeriodicalIF":1.6,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150987","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":"Addressing Access and Visualization Limitations in VNOTES: Evaluation of a Novel Laparoscopic Vaginal Speculum in a Porcine Model.","authors":"Yuebo Li, Shengdi Hou, Wenhui Li, Yuanyuan Wen, Ming Xue, Chang Zhou, Heming Sun, Huan Yu, Dingqing Feng, Jing Liang, Bin Ling","doi":"10.1177/15533506251410644","DOIUrl":"10.1177/15533506251410644","url":null,"abstract":"<p><p>BackgroundVaginal natural orifice transluminal endoscopic surgery (VNOTES) is a minimally invasive technique with significant clinical potential. However, its widespread adoption has been hindered by technical challenges, particularly in the establishment and stabilization of the surgical access platform. In conventional vaginal surgery, the operative field is often limited by a narrow operative field, poor visualization, and difficulty in standardized surgical training. To address these limitations, a novel laparoscopic vaginal speculum system was designed and developed to overcome the limitations of the existing technologies. We conducted animal trials were conducted to demonstrate its feasibility for VNOTES hysterectomy in a porcine model.MethodsThe laparoscopic vaginal speculum system is a flexible and simplified laparoscopic visualization system comprising a protective connecting sleeve, multichannel base, sealing ring, and control plate. This innovative device facilitates the establishment of the VNOTES surgical access platform via a laparoscopic-guided approach, effectively replacing traditional transvaginal surgery used during the initial phase of the procedure.ResultsVNOTES hysterectomy was successfully performed in four Bama pigs. The mean operative time was 81.75 ± 18.91 minutes, with an estimated blood loss of 10.75 ± 3.40 mL. No intraoperative complications were observed. The system demonstrated excellent flexibility and provided clear and stable surgical visualization.ConclusionsThe trial demonstrate that this system provides a simplified, stable, and visualizable approach for establishing VNOTES surgical access platform. It offers sufficient workspace for laparoscopic instruments and enhances procedural flexibility, potentially improving the safety and efficiency of VNOTES surgery.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"300-305"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847086","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":"Comparing the Effects of Absorbable Polyglycolic Acid-Coated Tube and Polypropylene Suture Repairs on Stricture Formation in Biliary Anastomosis.","authors":"Osman Bulut, Sidika Findik, Abdulkadir Celik, Arslan Hasan Kocamaz, Omer Kisi, Alper Varman, Selman Alkan, Ibrahim Kilinc, Mustafa Senturk","doi":"10.1177/15533506251407730","DOIUrl":"10.1177/15533506251407730","url":null,"abstract":"<p><p>BackgroundOur study aimed to compare the effects of repair using polypropylene suture material vs polyglycolic acid-coated (PGA) tube on the development of biliary strictures in rat common bile duct incisions.MethodsThirty female rats were randomly divided into three groups. A controlled defect was created in the common bile duct. In Group 1, the defect was repaired with 8/0 polyglycolic acid; in Group 2, with 8/0 polypropylene; and in Group 3, with 8/0 polyglycolide-co-lactide followed by wrapping with an absorbable polyglycolic acid mesh tube. In the second surgical step, at 3 months postoperatively, blood samples were again taken from all subjects, liver biopsies were obtained, and the repaired bile duct area was resected for histopathological evaluation. Liver biopsies obtained before bile duct repair and at 3 months after repair were compared among the groups. Anastomotic sites and proximal bile duct diameters were compared between groups at 3 months post-repair.ResultsPostoperative ALT and GGT levels were significantly higher in Group 1 rats, while ALP levels were statistically significantly lower in Group 2 rats. Epithelial hyperplasia was detected in 20% of rats in Group 3, with fewer proliferative fibroblasts and less collagen scar tissue compared with those in other groups. The Portal edema rate was significantly lower in Group 3 than in Groups 1 and 2.ConclusionsThe use of PGA -coated tubes after PGLA suturing suggests that these tubes may reduce strictures in biliary repair in rats by maintaining a wider anastomotic diameter.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"217-224"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145715788","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":"Understanding Patient Perspectives on Innovative Surgical Procedures: A Qualitative Evidence Synthesis and Framework for Informed Consent.","authors":"Sanjay Kumar Yadav, Devam Baderiya, Aman Bakhsh, Mohammed M Imran, Dhananjaya Sharma","doi":"10.1177/15533506251413070","DOIUrl":"10.1177/15533506251413070","url":null,"abstract":"<p><p>BackgroundSurgical innovation drives progress but challenges conventional models of informed consent.ObjectiveTo synthesize qualitative evidence on how adult patients perceive, understand, and decide about innovative surgical procedures, and to develop an evidence-informed framework for ethical, patient-centered consent.MethodsA qualitative evidence synthesis following PRISMA 2020 guidelines was conducted for studies exploring patient perspectives or decision-making in the context of surgical innovation. Confidence in each qualitative finding was assessed using the GRADE-CERQual approach.ResultsEight studies were included. Thematic synthesis identified recurrent patterns and meta-themes across qualitative and mixed-methods data. Ten meta-themes emerged, highlighting that patients view innovation with optimism and trust but limited comprehension of uncertainty. Multimedia and interactive consent tools improved understanding. A five-pillar framework was derived which prompted the construction of a 10 point structured informed consent proforma-clarifying novelty, disclosing uncertainty, acknowledging surgeon experience, using layered information, and supporting shared decision-making.ConclusionPatients' perceptions of surgical innovation are shaped more by trust and perceived progress than by understanding of risk. Ethical, layered, and dialogue-driven consent can transform uncertainty into informed partnership.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"244-253"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834863","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":"Response to the Letter to the Editor: \"Data, Algorithms, and Ethics in Virtual Reality Based Medical Education\".","authors":"Ryan M Knobovitch, Junko Tokuno, Howard B Fried, Tamara E Carver, Gerald M Fried","doi":"10.1177/15533506251400408","DOIUrl":"10.1177/15533506251400408","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"310-311"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565555","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":"Quality of Life After Robotic Abdominal Surgery - A Retrospective Cross-Sectional Study.","authors":"Jessica Stockheim, Felix-Lukas Fiedler, Mihailo Andric, Sara Al-Madhi, Maximilian Dölling, Roland Croner, Aristotelis Perrakis","doi":"10.1177/15533506251392428","DOIUrl":"10.1177/15533506251392428","url":null,"abstract":"<p><p>BackgroundRobotic procedures are still increasing in abdominal surgery. Yet, little is known about the postoperative Quality of Life (pQoL) after these procedures. The aim of this study was to determine the pQoL of patients who underwent robotic-assisted abdominal surgery.MethodsAs a cross-sectional, retrospective study, several validated questionnaires were used to evaluate the pQoL. After confirmed consent patients who underwent robotic upper gastrointestinal tract (UGI), hepatopancreatobiliary (HPB), and colorectal (CR) procedures between 03/2020 and 03/2023 were enrolled. Subgroup analysis referred to oncologic and non-oncologic indications, postoperative time periods and age >70 years. Scoring was adjusted to a scale of 0 to 100 (as the best QoL) for comparability.ResultsA total of 197 patients were included (<i>n</i> = 111 for oncological indications, <i>n</i> = 86 for functional, non-oncological indications). Organ-related subgroup analyses showed an overall score of >70 for each group (oncologic: UGI: 75.6 ± 16.6; HPB: 85.6 ± 15.7; CR: 81.9 ± 18.5 and non-oncologic: UGI: 76.0 ± 14.8; HPB: 78.9 ± 13.2; CR: 82.4 ± 6.6). A decline in pQoL was observed during the second year after surgery, evident in both oncologic (<1 year: 80.7 ± 16.2 vs 1-2 years: 73.1 ± 19.7 vs 2-3 years: 88.4 ± 11.2, <i>p</i> = .005) and non-oncologic patients (<1 year: 80.7 ± 10.1 vs 1-2 years: 69.7 ± 18.9 vs 2-3 years: 75.6 ± 12.5, <i>p</i> = .033). PQoL was similar for patients under and above 70 years.ConclusionThe overall pQoL for abdominal surgery was good regardless of the indication or the organ system. A decline in the pQoL was noted during the second year after surgery. Due to the retrospective design and small subgroups, further longitudinal studies are required to determine the long-term QoL and influencing factors.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"205-216"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145482706","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":"Development of a Bariatric Surgery Specific Artificial Intelligence Large Language Model: BariatricSurgeryGPT.","authors":"Berk B Ozmen, Ibrahim Berber, Jerry T Dang, Graham S Schwarz, Matthew Kroh","doi":"10.1177/15533506251400130","DOIUrl":"10.1177/15533506251400130","url":null,"abstract":"<p><p>BackgroundCommercially available large language models (LLMs) have demonstrated impressive capabilities in processing vast datasets and generating coherent narratives. However, their lack of domain-specific knowledge limits their reliability in clinical applications. This study aimed to develop and evaluate BariatricSurgeryGPT, a fine-tuned LLM specifically tailored for bariatric surgery to provide more accurate and clinically relevant responses to bariatric surgery-related questions.MethodsWe obtained 8764 bariatric surgery research abstracts published between January 1, 2020, and January 1, 2024, from PubMed. These abstracts were preprocessed and tokenized to fine-tune a pre-trained GPT-2 model using PyTorch and HuggingFace frameworks. The model's performance was evaluated using BLEU, METEOR, and ROUGE-1 scores on 20 clinically relevant bariatric surgery questions, each tested across nine temperature settings (0.1-0.9) for both the fine-tuned and baseline GPT-2 models, yielding 360 total evaluation instances.ResultsBariatricSurgeryGPT demonstrated consistent improvements over the baseline GPT-2 model across all metrics. The fine-tuned model achieved a BLEU score of 0.165 (vs 0.147 for baseline, 12.8% improvement), a METEOR score of 0.633 (vs 0.585, 8.2% improvement), and a ROUGE-1 score of 0.267 (vs 0.243, 9.7% improvement). These improvements indicate enhanced precision, recall, and semantic relevance in generating bariatric surgery-specific content.ConclusionBariatricSurgeryGPT represents the first domain-specific LLM for bariatric surgery and demonstrates the feasibility of developing specialty-specific AI tools with improved accuracy for clinical applications. The specialty-specific models could enhance surgical education through interactive learning tools, improve patient communication via personalized educational materials, and support clinical decision-making by providing evidence-based information synthesis.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"276-282"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145557782","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":"Letter to the Editor: Can Artificial Intelligence Revolutionise Surgical Decision-Making for Appendectomy?","authors":"Marko Bašković","doi":"10.1177/15533506251409002","DOIUrl":"10.1177/15533506251409002","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"312-313"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805137","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":"Three Versus Two-Rows Circular Stapler in Colorectal Anastomosis: Short Term Outcomes.","authors":"Stefano Agnesi, Marcello Schiavo, Andrea Balla, Ivano Sciannamea, Pietro Pizzi, Mattia Pizzi, Massimiliano Casati","doi":"10.1177/15533506251413073","DOIUrl":"10.1177/15533506251413073","url":null,"abstract":"<p><p>AimAnastomotic leakage (AL) is a significant complication after colorectal cancer surgery, with serious clinical and economic consequences. Circular staplers (CSs) with 3 staple rows of different heights may enhance anastomotic integrity and perfusion compared to conventional two-row CSs. The aim of the present study is to compare the short-term outcomes of 2 vs three-row CSs in colorectal anastomosis in case of left hemicolectomy, sigmoidectomy and anterior resection of the rectum for cancer.MethodThis is a retrospective analysis of prospectively collected data. All consecutive patients with left or sigmoid colon or rectal cancer who underwent elective resection with primary anastomosis from 2013 to 2025 were included. Patients were included in the control or in the intervention group if two-row or three-row CS was used during surgery, respectively. AL rate and its severity grade were compared between groups, and the prognostic impact of stapler type on AL onset was assessed.ResultsOne-hundred-thirty-six and 109 patients were included in the control and in the intervention group, respectively. AL rate was significantly higher in the control group in comparison to the intervention group (11.8% vs 3.7%; <i>P</i> = 0.02). Moreover, patients in the control group had significantly longer hospital stays than the intervention group (<i>P</i> = 0.04). On multivariate analysis, the use of the two-row CSs is an independent adverse predictor of AL (Odds Ratio 3.79; <i>P</i> = 0.03).ConclusionBased on our findings the use of three-row CS is associated with a lower postoperative AL rate and shorter LOS in comparison to the two-row CS.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"254-262"},"PeriodicalIF":1.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834817","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}