Innovative Surgical Sciences最新文献

{"title":"Comprehensive interdisciplinary treatment of an orbital lymphatic-venous malformation: a case report.","authors":"Céline Tourbier, Bilal Msallem, Martin Thanh-Long Takes, Florian M Thieringer, Lukas B Seifert","doi":"10.1515/iss-2025-0010","DOIUrl":"10.1515/iss-2025-0010","url":null,"abstract":"<p><strong>Objectives: </strong>Orbital lymphatic-venous malformations (LVMs) are rare congenital anomalies that can cause significant functional and aesthetic impairments.</p><p><strong>Case presentation: </strong>This case report details the comprehensive treatment of a 47-year-old male with a longstanding orbital combined slow-flow vascular malformation. Diagnostic evaluation included magnetic resonance imaging and a sonographically guided core needle biopsy, which confirmed a benign lymphatic-venous malformation. The treatment started with minimally invasive sclerotherapy to reduce lesion size, followed by surgical debulking to alleviate proptosis and mechanical restrictions. Finally, reconstructive surgery addressed residual eyelid deformities, including ectropion and ptosis. Post-treatment outcomes demonstrated stable visual function, improved eyelid position, and a significant enhancement in the patient's aesthetic appearance and quality of life.</p><p><strong>Conclusions: </strong>The staged, multimodal approach underscores the importance of individualized treatment planning and interdisciplinary collaboration. This case highlights the potential for excellent functional and aesthetic outcomes in the management of complex orbital LVMs when nonsurgical and surgical techniques are strategically combined.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"11 3","pages":"177-182"},"PeriodicalIF":1.3,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who takes the lead in oral surgery simulation? Students' perceptions and practical skills towards virtual reality and phantom model training: a comparative study.","authors":"Juliane Kröplin, Constanze Veronika Friedrich, Lisa Harms, Ingo Buttchereit, Jan-Hendrik Lenz, Bernhard Frerich","doi":"10.1515/iss-2025-0008","DOIUrl":"10.1515/iss-2025-0008","url":null,"abstract":"<p><strong>Objective: </strong>Virtual reality (VR) simulators are considered a promising tool for significantly enhancing surgical skills. This study aims to compare the use of a VR simulator with a conventional phantom model in oral surgery training. The findings should contribute to the further development of oral surgery simulation training and help maximize the innovative benefits of VR-based training.</p><p><strong>Methods: </strong>This prospective, cross-sectional, single center study analyzed students' competence in performing an osteotomy on a displaced tooth 38. Participants were dental students in their 5th semester at a University Medical Center in Germany. The study compared a VR simulator with a phantom model. After completing the exercise, students filled out a questionnaire consisting of both standardized and open-ended questions to allow for a comprehensive subjective evaluation of the training experience.</p><p><strong>Results: </strong>A total of 22 students took part in the study (12 female, 10 male). None had previously performed the exercise on a patient. From the students' perspective, both training methods were easy to learn (VR:2.0; Ph: 2.1; p=0.642). Individual feedback highlighted that the VR simulator's main advantages were sustainability (n=12) and objectivity (n=5). However, standardized responses indicated that the phantom model was rated as more realistic, particularly regarding anatomical representation (p<0.001), haptic feedback (p<0.001) tooth removal (p<0.001) and osteotomy steps (p<0.001). Both exercises were equally engaging for students (VR:1.8; Ph:1.5; p=0.162).</p><p><strong>Conclusion: </strong>Simulation-based training is an engaging way for students to learn surgical tooth removal. Currently, conventional simulation is subjectively perceived as superior to VR simulation, particularly in terms of realism. However, VR simulation allows for a more objective assessment of performance and is considered superior to the phantom model in terms of sustainability. Further technological advancements and improvements in realism could help maximize the innovative benefits of VR-based training.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"10 3","pages":"167-177"},"PeriodicalIF":1.2,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12552031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145379291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical training on non-living models: proposal for basic training.","authors":"Mara Franza, Giovanni Maria D'Antonio, Anna Barbara Di Stefano, Emanuele Cammarata, Giovanni Zabbia, Francesca Toia","doi":"10.1515/iss-2024-0039","DOIUrl":"10.1515/iss-2024-0039","url":null,"abstract":"<p><strong>Objectives: </strong>Microsurgery is an essential skill for plastic surgeons and a basic microsurgical course should be integrated into all plastic surgery residents' training programs, as mastering this technique cannot be reached only through observation and requires regular practice. Despite living models better simulate reality, non-living models have been shown to be valid tools for basic/intermediate microsurgical training. While many single preclinical exercises are described in the literature, there is lack of proposals for a complete basic program on non-living models. The aim of this study is to propose a basic microsurgical program entirely based on non-living models and to evaluate its feasibility with a cross-sectional study that analyses the outcomes of its application via the \"Queen Mary University London microsurgery global rating scale\" scoring system.</p><p><strong>Methods: </strong>Nine different exercises for microsurgical training on non-living models were chosen based on a literature review. A basic step-by-step microsurgical training program was built. The program was proposed to the Plastic Surgery residents of our unit through a five-day training, during 2020-2023. No participants 'selection was made. All participants were examined with a practical test before and after the proposed program. The results of pre- and post-training test were collected and analysed.</p><p><strong>Results: </strong>Each trainee was able to complete a posterior-wall-first technique end-to-end anastomosis on the chicken thigh femoral artery with no major mistakes at the end of the program. Moreover, the data analysis revealed a statistically significant improvement of each evaluated skill after the training.</p><p><strong>Conclusions: </strong>The proposed basic program is easy to organize and allows the trainee to develop the basic microsurgical skills needed to move to advanced training on living animals or on guided clinical practice.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"11 2","pages":"131-139"},"PeriodicalIF":1.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hot water bottle burn injuries: a 10-year retrospective analysis of incidence and potential predictors in Germany.","authors":"Moritz Rudolf Milewski, Frederik Schlottmann, Anieto Onochie Matthias Enechukwu, Nico Franke, Martynas Tamulevicius, Louisa Jutta Dietz, Luis Alberto Barros Navarro, Lukas Wellkamp, Khaled Dastagir, Peter Maria Vogt, Vincent März","doi":"10.1515/iss-2024-0042","DOIUrl":"10.1515/iss-2024-0042","url":null,"abstract":"<p><strong>Objectives: </strong>Hot water bottles are widely used for warmth and therapeutic relief, but improper use can lead to burns, ranging from superficial to full-thickness skin injuries. Following the natural gas shortage caused by the complete halt of Russian gas supplies, European countries experienced a sharp increase in hot water bottle-related burns. However, data for Germany were not yet provided. This study examines the incidence of hot water bottle burns over a 10-year period, exploring potential correlations with natural gas prices, natural gas consumption, ambient temperature, and respiratory infection rates.</p><p><strong>Methods: </strong>A retrospective single-center analysis of 88 patients who sustained hot water bottle burns from 2014 to 2024 was conducted. Patient data, including burn severity and demographic information, were extracted from hospital records. Monthly counts of acute respiratory infections (ARIs), ambient temperature, natural gas price and gas consumption data were also analyzed. A Poisson regression model was applied to assess the association between hot water bottle burns and the mentioned independent variables.</p><p><strong>Results: </strong>The majority of burns (81.8 %) were second-degree injuries, primarily affecting women (81.8 %). Burns were most common on the lower trunk, thighs, and forearms. The Poisson regression model revealed that for every 1 °C increase in ambient temperature, the incidence of burns decreased by 7 % (IRR=0.93, 95 % CI: 0.88-0.97). However, no significant association was found between ARI incidence, natural gas price and burn occurrence. There was no significant increase of water bottle burns during the recent European energy crisis in Germany.</p><p><strong>Conclusions: </strong>Hot water bottle burns are more frequent during colder months, particularly among women. Natural gas price or natural gas consumption seems like not playing an equivalent role in Germany as in other European countries. Public health efforts should focus on education and prevention strategies to reduce these preventable injuries. Further research should explore additional factors that may influence burn rates.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"11 2","pages":"105-114"},"PeriodicalIF":1.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular considerations in autologous breast reconstruction using DIEP or MS-TRAM flaps: standard techniques, alternatives, and rescue strategies.","authors":"Theresa Promny, Andreas Arkudas, Paula Huberth, Raymund E Horch","doi":"10.1515/iss-2025-0011","DOIUrl":"10.1515/iss-2025-0011","url":null,"abstract":"<p><strong>Objectives: </strong>Microsurgical breast reconstruction is an established method following mastectomy; however, various factors significantly influence the complication rate. This analysis evaluates the impact of vascular anastomosis techniques, previous surgeries, and radiotherapy on the success rate of microsurgical breast reconstruction.</p><p><strong>Methods: </strong>In a retrospective data analysis of 396 patients who underwent 447 flap procedures (single or bilateral microsurgical breast reconstruction) using tissue from the lower abdomen (either DIEP or MS-TRAM flaps), the type of venous and arterial anastomoses, the initial findings or surgical specifics at the thoracic recipient site and their influence on complications were examined.</p><p><strong>Results: </strong>Anastomosing two veins per flap did not result in a significant reduction of major complications. Flap loss was significantly more common when standard venous anastomosis to the internal mammary vein was not used, underscoring their role as the preferred recipient vessels. No major complications were observed in patients receiving a caudal anastomosis to the internal mammary artery. Patients with prior radiotherapy exhibited an increased need for arterial revisions. All documented seromas and infections occurred in irradiated patients.</p><p><strong>Conclusions: </strong>A differentiated surgical plan that considers optimal anastomosis techniques, supercharging strategies, and individual risk factors is crucial to reducing complications. Further studies are needed to optimize patient-specific strategies.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"11 2","pages":"123-130"},"PeriodicalIF":1.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness and feasibility of short-course simulator training for robotic surgery novices - a randomized controlled trial (FastSim trial).","authors":"Sotirios Emmanouilidis, Kürsat Kirkgöz, Tina Groß, Benjamin Müssle, Anna Klimova, Daniel Stange, Thilo Welsch","doi":"10.1515/iss-2025-0003","DOIUrl":"10.1515/iss-2025-0003","url":null,"abstract":"<p><strong>Objectives: </strong>As robot-assisted surgery (RAS) is on the rise, feasible and effective simulator training for surgical residents is needed. This study compares the effectiveness and feasibility of two compact simulator training protocols on the DaVinci skills simulator (dVSS) for preparing robotic surgery novices.</p><p><strong>Methods: </strong>In this randomized controlled trial, RAS novices were randomized 1:1 into a conventional group (Control), including four repetitions of five simulator exercises in two sessions, and a fast group (Fast), with two repetitions of the same five simulator exercises in a single training session. The primary endpoint was the mean efficiency score achieved in the final exercise.</p><p><strong>Results: </strong>Fifty-two participants (22 males) were randomized, 26 in each group. Forty-eight per cent were between 30 and 50 years old and most of the participants were residents (44.2 %) or consultants (42.3 %), 13.5 % were students. The primary endpoint results showed a mean efficiency score of 48.2 ± 26.7 (Fast) vs. 52.3 ± 30.4 (Control) in the intention-to-treat analysis (p=0.527). The most significant improvement in efficiency and penalty scores was observed between the 1st and 4th repetitions in the control group. Participants over 50 years old and consultants performed worse than younger participants, students and resident doctors. Participants interested in robotic surgery outperformed those with little or no interest.</p><p><strong>Conclusions: </strong>A training of 10-20 exercises on the dVSS with ascending levels is insufficient to succeed in complex simulation exercises but improves performance and motivation. These findings emphasize the need for tailored training programs and continuous skill development in robotic surgery.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"11 2","pages":"115-122"},"PeriodicalIF":1.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to an enhanced recovery protocol in colorectal surgery before and during a structured implementation - a prospective cohort study from nine German hospitals.","authors":"Wolfgang Schwenk, Christoph Strey, Sven Flemming, Monsserat Girona-Johannkämper, Wolfgang Wendt, Ibrahim Darwich, Hannes Neeff, Mark Banysch, Sandra Henn, Michael Scheruhn","doi":"10.1515/iss-2025-0004","DOIUrl":"10.1515/iss-2025-0004","url":null,"abstract":"<p><strong>Objectives: </strong>Enhanced recovery protocols (ERP) are considered as state of the art in perioperative management of elective colorectal resections. However, adoption of ERP in the clinical routine is not easy and a structured implementation process is recommended. The aim of the present data analysis was to evaluate the learning curve of the structured implementation of an enhanced recovery protocol in elective colorectal resections based on adherence to recommended ERP elements and clinical outcomes.</p><p><strong>Methods: </strong>During a 12-month structured implementation of an ERP in nine hospitals, perioperative management data were prospectively documented. Patients during the 3-month preparation phase were differentiated as a comparison group with traditional management from patients during the clinical ERP implementation. In addition, the 9-month ERP application phase was divided into three equal sections. Adherence to 23 recommended ER elements and to the pre-, intra- and postoperative elements was calculated.</p><p><strong>Results: </strong>One thousand one hundred fifty-three patients (48.3 % female) were included. Traditional perioperative treatments were applied in 313 patients (preERP), while 840 patients (249, 297 and 294 during months during the first [ERP3], second [ERP6] and last 3 months [ERP9] interval) were treated according to the enhanced recovery protocol. Overall preERP ERP-adherence was 52 (IQR: 48-57)% in 9 hospitals but increased to 87 (78-91)% at the end of ERP-implementation. Functional recovery after surgery increased from preERP to ERP9, and postoperative length of stay was reduced from 7 (6 - 8) to 5 (5 - 7) days. Major improvements in overall and preoperative ERP adherence were achieved during the first 3 months, while postoperative ERP adherence took 6-9 months to reach best results.</p><p><strong>Conclusions: </strong>Structured implementation of an enhanced recovery protocol resulted in high adherence to 23 ERP-elements within 12 months. Although major achievements occurred during the first 3 months of clinical ERP utilization, a total of 9 months are needed especially to improve postoperative ERP-adherence.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"11 2","pages":"95-104"},"PeriodicalIF":1.3,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148266519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterotopic pancreas and malakoplakia in abscessing intrahepatic tumor - a case report.","authors":"Marc A Reschke, Phil Meister, Sven A Lang, Dirk Theegarten, Tom F Ulmer, Hideo A Baba, Ulf P Neumann, Lara Heij, Sophia M Schmitz","doi":"10.1515/iss-2025-0002","DOIUrl":"10.1515/iss-2025-0002","url":null,"abstract":"<p><strong>Objectives: </strong>The presence of heterotopic pancreatic tissue or malacoplakia in the liver is very uncommon and rarely becomes symptomatic.</p><p><strong>Case presentation: </strong>Here we report of a 57-year-old female patient who received left-sided hemihepatectomy due to a tumor resembling intrahepatic abscess. Histopathological examination revealed both heterotopic pancreas and malakoplakia.</p><p><strong>Conclusions: </strong>We discuss this case in relation to the existing literature. As far as we know, this is the first reported case of simultaneous presence of these two rare entities.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"10 4","pages":"241-244"},"PeriodicalIF":1.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145828859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts DGNC.","authors":"","doi":"10.1515/iss-2025-2007","DOIUrl":"https://doi.org/10.1515/iss-2025-2007","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"10 Suppl1","pages":"371-375"},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts DGPRÄC.","authors":"","doi":"10.1515/iss-2025-2008","DOIUrl":"https://doi.org/10.1515/iss-2025-2008","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"10 Suppl1","pages":"376-381"},"PeriodicalIF":1.7,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11917186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}