Innovative Surgical Sciences最新文献

{"title":"Augmented reality and optical navigation assisted orbital surgery: a novel integrated workflow.","authors":"Nikolay Tonchev, Giulia Renieri, Klaus-Peter Stein, Belal Neyazi, Max Willgerodt, Hagen Thieme, I Erol Sandalcioglu, Karl Hartmann","doi":"10.1515/iss-2023-0064","DOIUrl":"10.1515/iss-2023-0064","url":null,"abstract":"<p><strong>Objectives: </strong>Due to the close topographical relationship of functional relevant anatomic structures, limited space and cosmetic aspects orbital surgery will remain a challenging discipline. Therefore, novel technical capabilities are necessary for further surgical progress. We here tested the integration of augmented reality and optical navigation in one workflow for interdisciplinary decision-making, feasibility and intraoperative guidance.</p><p><strong>Methods: </strong>High-resolution contrast-enhanced MRI and CT scans were automated and manual-assisted segmented to achieve a detailed three-dimensional (3D) model of the individual patho-anatomical relationships. Augmented reality was used for interdisciplinary preoperative planning and intraoperative intuitive navigation. Mayfield clamp head holder in combination with optical surface matching registration assured navigation assisted microsurgery.</p><p><strong>Results: </strong>Combinations of different MRI-sequences and CT-scans were necessary for detailed 3D-modeling. Modeling was time consuming and only viable in the hands of medical, surgical and anatomical trained staff. Augmented reality assured a quick, intuitive interdisciplinary orientation. Intraoperative surface matching registration enabled precise navigation in the orbital space.</p><p><strong>Conclusions: </strong>Optical Navigation and microscope integration achieved a straightforward microsurgical workflow and should be implemented regularly. Augmented reality represented a useful tool for preoperative interdisciplinary planning and intraoperative intuitive orientation. It further stated an excellent educational tool.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"10 2","pages":"91-98"},"PeriodicalIF":1.2,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800492","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":"Registry or randomization - must it be evidence or could it be coincidence?","authors":"Olga Radulova, Florian Oehme, Sandra Korn, Christian Praetorius, Marius Distler, Jürgen Weitz","doi":"10.1515/iss-2022-0028","DOIUrl":"10.1515/iss-2022-0028","url":null,"abstract":"<p><p>Over the years, clinical registries and randomized controlled trials gained acceptance. With increasing experience, it was possible to obtain knowledge of benefits and limitations in both designs. During the last years, the research focus was placed on new study concepts such as register-based randomized controlled trials intending to merge the benefits of evidence obtained by RCTs and clinical registers. In this review, we aim to provide an overview of the evolution and the present stage of clinical trials. While doing so, we outline past experience and look ahead toward improving models for high-quality clinical trials.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"10 2","pages":"65-71"},"PeriodicalIF":1.2,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800494","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":"Influence of medical didactic training on the self-efficacy and motivation of clinical teachers.","authors":"Franziska Schydlo, Jasmina Sterz, Maria-Christina Stefanescu, Martina Kadmon, Sarah König, Miriam Rüsseler, Felix Walcher, Farzin Adili","doi":"10.1515/iss-2023-0073","DOIUrl":"10.1515/iss-2023-0073","url":null,"abstract":"<p><strong>Objectives: </strong>Due to increasing workload and rising expectations for both undergraduate and speciality training in medicine, teaching in a clinical environment can be challenging. The \"Train the Trainer\" course, developed by CAL (Chirurgische Arbeitsgemeinschaft Lehre, Deutsche Gesellschaft für Chirurgie (DGCH)), aims to assist clinical teachers in their task. This study investigates the effect the course has on participants' self-efficacy and teaching motivation.</p><p><strong>Methods: </strong>Prior to attending the course, participants anonymously completed a 50-question pre-course questionnaire using standardised questions to gather information on biographical data teaching experience, and validated tools measuring teaching motivation and self-efficacy (PRE). Directly after completing the course, participants evaluated it using a 25-question post-course questionnaire (POST1). At least 12 months after the course, participants received a follow-up questionnaire (POST2) by mail. This 44-question form aimed to gather biographical data, review the teaching methods participants had used since their training, and reassess their teaching motivation and self-efficacy.</p><p><strong>Results: </strong>Between June 2016 and October 2019, 20 TTT courses were held across six German medical faculties. Data were gathered from 241 participants. After the course, 182 POST2 questionnaires were mailed, 61 of which were returned (equals a 39 % return rate). The findings revealed significant increases in teacher self-efficacy (p=0.0025), identified regulation (p=0.0000), and career motivation (p=0.0044). In contrast, there was a significant decrease in introjected regulation (p=0.0048). When comparing the participants to a reference sample selected from literature, significant differences emerged in intrinsic motivation (p=0.0000) and amotivation (p=0.0025).</p><p><strong>Conclusions: </strong>Course participants already showed strong intrinsic motivation and self-efficacy before taking the course. After completing it, their confidence to meet specific teaching demands based on their abilities had increased. Notably, changes in motivational dimensions identified and introjected regulation point towards a shift in motivational sources, indicating a more self-regulated approach towards participants' teaching activities. Further research is needed to determine how much of this change was due to course participation.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"9 2","pages":"99-108"},"PeriodicalIF":1.7,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11294303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890308","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":"A note from the Editor-in-Chief.","authors":"","doi":"10.1515/iss-2024-0011","DOIUrl":"https://doi.org/10.1515/iss-2024-0011","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"9 1","pages":"1"},"PeriodicalIF":1.3,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200658","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":"What's new in surgery - essentials 2023: the ISS young surgeon issue.","authors":"Juliane Kröplin","doi":"10.1515/iss-2024-0009","DOIUrl":"10.1515/iss-2024-0009","url":null,"abstract":"","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"8 4","pages":"195-196"},"PeriodicalIF":1.3,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177056","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":"Imaging in reconstructive microsurgery - current standards and latest trends.","authors":"Beate Blank, Aijia Cai","doi":"10.1515/iss-2023-0040","DOIUrl":"10.1515/iss-2023-0040","url":null,"abstract":"<p><p>In microsurgery, many different imaging techniques are available in both flap and lymphatic surgery that all come with their own advantages and disadvantages. In flap surgery, CT angiography is considered as the gold standard. Among others, Doppler ultrasound, color Doppler ultrasound, ICG, and smartphone-based thermal cameras are valuable imaging techniques. In lymphatic surgery, photoacoustic imaging, laser tomography, contrast-enhanced magnetic resonance imaging, and high frequency ultrasound stand available to surgeons next to the current standard of lymphoscintigraphy. It is crucial to know the advantages and disadvantages to various techniques and highly adviced to microsurgeons be capable of using a variety of them.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"8 4","pages":"227-230"},"PeriodicalIF":1.3,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10949116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177055","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":"An update on liver surgery – a new terminology and modern techniques","authors":"V. Tripke, Nils Sommer","doi":"10.1515/iss-2023-0032","DOIUrl":"https://doi.org/10.1515/iss-2023-0032","url":null,"abstract":"Abstract Liver surgery is the cornerstone of the curative treatment of malignant liver tumors. However, the liver anatomy is very complex, and liver surgery is still associated with relevant morbidity despite many technical advances. The Brisbane nomenclature is used worldwide to classify liver resection. However, this nomenclature has several limitations as multiple terms are used for the same type of resection. Non-anatomical resections, multiple resections, and combined bilio-vascular resections were not mentioned. Therefore, new terminologies have been proposed for the precise and simple classification of liver resection. Furthermore, in recent years, many technical innovations have been introduced in liver surgery, such as 3D imaging systems and indocyanine green fluorescence, for better preoperative and intraoperative identification of tumor localization and critical vascular structures. Minimally invasive techniques are used more frequently in liver surgery. Potential benefits include less intraoperative blood loss, less pain, and a shorter hospital stay. The implementation of robotic systems also has an impact on liver surgery, and the number of cases reported in the literature is constantly increasing. The potential benefits of robotic liver resection over laparoscopic liver resection will be the subject of future studies.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"57 6","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139386665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endovascular repair of the aortic arch","authors":"Florian Kursch, Panagiotis Doukas","doi":"10.1515/iss-2023-0029","DOIUrl":"https://doi.org/10.1515/iss-2023-0029","url":null,"abstract":"Abstract Objectives The gold standard for the treatment of pathologies of the aortic arch remains the open surgical reconstruction of the affected segments. However, endovas-cular treatment options have emerged that eliminate the need for invasive open surgery. Several endograft devices – with fenestrations or branches for the supraaortic vessels – are currently available to address different pathologies and anatomical variations. Parallel-graft techniques and in situ fenestrations expand the treatment options for emergent cases. In this selective review of the literature of 2020 and 2021, we summarize the current chances and challenges of endovascular aortic repair. Content Reported mortality rates range from 0 to 13.2 %. Although technical success rates for fenestrated and branched devices are promising (98 %), stroke rates remain a relevant issue (10 and 3 % for BTEVAR and FTEVAR respectively). The reported technical success rate for in situ fenestrations is also encouraging (94 %) and the stroke rates acceptable (5 %). Parallel-graft techniques are associated with high early and late endoleak rates (early 76 %; late 31 %), but still hold a valuable place in the treatment of emergent cases or in bail-out situations. Summary and Outlook The endovascular repair of the aortic arch expands the range of patients with pathologies of the arch eligible for treatment to those unfit for open surgery offering a minimally invasive, yet technically challenging procedure. More data and meta-analyses are needed to define the benefits and drawbacks of this promising treatment option in an aging population with increasing co-morbidities.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"25 ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139172810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual planning for mandible resection and reconstruction.","authors":"Florian Andreas Probst, Paris Liokatis, Gerson Mast, Michael Ehrenfeld","doi":"10.1515/iss-2021-0045","DOIUrl":"https://doi.org/10.1515/iss-2021-0045","url":null,"abstract":"<p><p>In mandibular reconstruction, computer-assisted procedures, including virtual surgical planning (VSP) and additive manufacturing (AM), have become an integral part of routine clinical practice. Especially complex cases with extensive defects after ablative tumor surgery benefit from a computer-assisted approach. Various CAD/CAM-manufactured tools such as surgical guides (guides for osteotomy, resection and predrilling) support the transition from virtual planning to surgery. Patient-specific implants (PSIs) are of particular value as they facilitate both osteosynthesis and the positioning of bone elements. Computer-based approaches may be associated with higher accuracy, efficiency, and superior patient outcomes. However, certain limitations should be considered, such as additional costs or restricted availability. In the future, automation of the planning process and augmented reality techniques, as well as MRI as a non-ionizing imaging modality, have the potential to further improve the digital workflow.</p>","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"8 3","pages":"137-148"},"PeriodicalIF":1.3,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10709695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138811176","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":"Anticoagulation management in elderly patients with proximal femur fractures – overview of current concepts","authors":"Yasmin Youssef, Anna K. I. M. Dietrich, Annika Hättich","doi":"10.1515/iss-2023-0030","DOIUrl":"https://doi.org/10.1515/iss-2023-0030","url":null,"abstract":"Abstract Objectives Proximal femur fractures (PFF) are common injuries in elderly patients and can have considerable effects on their quality of life, morbidity, and mortality. Due to pre-existing comorbidities, the prevalence of anticoagulated patients is increasing. The right timing for surgery and perioperative anticoagulation treatment remains controversial. Content This overview aims to summarize current practices in the pre- and postoperative anticoagulation management and the recommended time to surgery in elderly patients with PFF. Summary and Outlook Time to surgery for anticoagulated patients is often prolonged due to worries about serious perioperative bleeding and higher transfusion demands. But the delay of surgical PFF treatment increases the risk for perioperative complications like pulmonary embolism, pneumonia, deep vein thrombosis and urinary tract infections. Early surgery can be achieved with a consistent and interdisciplinary perioperative anticoagulation management. Antiplatelets do not have to be discontinued and surgery should be performed early without delay. For patients taking vitamin K antagonists (VKA) an INR less than 1.5 is recommended prior to surgery, which can be achieved by pausing VKA intake or by administering vitamin K, prothrombin complex concentrate (PCC) or fresh frozen plasma (FFP). For the treatment with direct oral anticoagulants (DOAC) a plasma drug level of under 50 pg/mL is considered safe for surgery. If the plasma level can not be determined, a gap of 24 h between the last DOAC dose and surgery is recommended. The systemic administration of tranexamic acid can reduce overall blood loss and transfusion rates in anticoagulated patients with PFF. Surgical treatment of PFF should be performed within 24 h, as delayed surgery increases the risk for perioperative complications. This also applies to anticoagulated patients, when clinically appropriate. International and interdisciplinary guidelines are necessary to ensure early and appropriate treatment of anticoagulated elderly patients with PFF.","PeriodicalId":44186,"journal":{"name":"Innovative Surgical Sciences","volume":"63 2","pages":""},"PeriodicalIF":1.3,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138600723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}