Chirurgie (Heidelberg, Germany)最新文献

{"title":"[Open versus robotic-assisted repair of midline ventral hernias with a defect width 2-8 cm].","authors":"Mohamad El-Ahmar, Christoph Reißfelder","doi":"10.1007/s00104-026-02573-3","DOIUrl":"https://doi.org/10.1007/s00104-026-02573-3","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892968","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":"[Surgical teams in extraordinary stress environments : Education, mental resilience and simulation-based training].","authors":"Philipp Hube, Axel Franke, Christian Beltzer, Gerhard Achatz, Moritz Witzenhausen","doi":"10.1007/s00104-026-02556-4","DOIUrl":"https://doi.org/10.1007/s00104-026-02556-4","url":null,"abstract":"<p><p>Extraordinary stress situations create a dual challenge for surgical teams: they must make technical decisions under time pressure while maintaining communication, leadership and situational awareness. In trauma rooms, intraoperative crises, mass casualty incidents, military deployments and resource-limited environments, risks arise due to stress, cognitive narrowing, unclear roles and impaired team coordination. The literature describes surgical skills, simulation-based education, structured debriefing and resilience training as relevant components to increase reliable team performance. This narrative review summarizes educational concepts, assessment tools and training approaches. A longitudinal curriculum should integrate technical procedures, team communication, crisis leadership and stress regulation. Repeated interprofessional scenarios with realistic stressors, explicit learning objectives and validated feedback are suitable. Resilience is understood as an individual, team-based and organizational capability.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889011","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":"[Preoperative low-calorie diets for patients with a body mass index > 30 kg/m² undergoing nonbariatric surgery].","authors":"Alida Finze, Mirko Otto, Christoph Reißfelder","doi":"10.1007/s00104-026-02534-w","DOIUrl":"10.1007/s00104-026-02534-w","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"753-755"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220907","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":"[Influence of clinically significant portal hypertension on the risk of liver failure after liver resection].","authors":"Lukas Pollmann, Michael Ardelt, Utz Settmacher","doi":"10.1007/s00104-026-02546-6","DOIUrl":"10.1007/s00104-026-02546-6","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"751-752"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457838","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":"[Rare neuroendocrine neoplasms of the gastrointestinal tract].","authors":"Detlef K Bartsch","doi":"10.1007/s00104-026-02532-y","DOIUrl":"https://doi.org/10.1007/s00104-026-02532-y","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":"97 9","pages":"697-698"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815170","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":"OMW: Präsakraler neuroendokriner Tumor.","authors":"Detlef K Bartsch","doi":"10.1007/s00104-026-02531-z","DOIUrl":"10.1007/s00104-026-02531-z","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"726"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206453","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":"[Gender distribution in visceral surgery : 11 years visceral medicine congress -A call for equal opportunities].","authors":"Marika Ebner, Marie-Louise Witte, Jennifer Gill, Lea Pueschel, Heiner Wedemeyer, Henrike Lenzen, Katja Schlosser, Miriam Wiestler","doi":"10.1007/s00104-026-02491-4","DOIUrl":"10.1007/s00104-026-02491-4","url":null,"abstract":"<p><strong>Background and objective: </strong>Despite a growing proportion of women in surgery, there is a significant underrepresentation in clinical and academic leadership positions. The mechanisms are still poorly understood. The German Congress of Visceral Medicine, as the largest interdisciplinary medical congress in German-speaking countries, provides a suitable platform for investigating gender-specific representation patterns. The aim of this study was to analyze the gender distribution in various congress functions between 2013 and 2024 in order to identify potential structural inequalities.</p><p><strong>Material and methods: </strong>The gender distribution of speakers and chairs at the German Congress of Visceral Medicine from 2013 to 2024 was analyzed based on the official congress programs. After excluding gastroenterological, endoscopic and interdisciplinary sessions, the visceral surgery sessions were analyzed in the categories of abstract sessions, plenary sessions and industry symposia.</p><p><strong>Results: </strong>The analysis revealed a significant increase in the number of female speakers (r² = 0.585; p = 0.006) and chairs (r² = 0.777; p < 0.001). The proportion of female speakers significantly increased in both plenary sessions (r² = 0.600, p = 0.005) and abstract sessions (r² = 0.445, p = 0.025). An increase in the number of female chairs was also observed for plenary sessions (r² = 0.796; p < 0.001) and abstract sessions (r² = 0.678; p = 0.002). Parity could not be achieved except for chairs of abstract sessions. At industry symposia, speakers were male in 88-100%, and chairs were male in 100% of all cases. The congress presidency was held by men in 10 out of 11 years (92%). The Walter Kausch Medal and the Rudolf Pichlmayr Medal went exclusively to men (100%).</p><p><strong>Conclusion: </strong>The analysis reveals a persistent underrepresentation of female surgeons in prestigious conference roles. Women were predominantly represented in less visible formats, indicating structural barriers. Following the introduction of transparent selection procedures and gender parity requirements, a significant increase in female participation was observed. These results suggest that targeted institutional measures are suitable for promoting the representation of women in academic surgery and reducing existing imbalances.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"732-742"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517230","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":"[Lobectomy vs. total thyroidectomy in papillary thyroid cancer with intermediate risk].","authors":"Detlef K Bartsch","doi":"10.1007/s00104-026-02544-8","DOIUrl":"10.1007/s00104-026-02544-8","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"749-750"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414167","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":"[The innovative FRANCIS method-A case report : Combination of abdominoplasty and sublay repair with preservation of the umbilicus in postpartum rectus diastasis and umbilical hernia].","authors":"Miriam Tobanelli, Herwig Pokorny, Peter Koo, Wenzel Czedik-Eysenberg, Matthias Hofmann","doi":"10.1007/s00104-026-02522-0","DOIUrl":"10.1007/s00104-026-02522-0","url":null,"abstract":"<p><strong>Introduction: </strong>Postpartum rectus diastasis and abdominal wall insufficiency frequently cause functional and aesthetic complaints, including impaired core stability, pain, postural disorders and psychosocial burden. Concomitant umbilical hernias often require surgical treatment. Although current guidelines recommend minimally invasive procedures with mesh reinforcement, many patients remain dissatisfied with the cosmetic outcome. Therefore, treatment requires a combination of functional reconstruction and aesthetic restoration. Preservation of the umbilical viability represents a particular surgical challenge. For this purpose, the FRANCIS technique (females postpartum with rectus diastasis benefit from abdominoplasty in navel-sparing technique combined with intervention in sublay technique) was developed, combining a navel-sparing abdominoplasty with a retromuscular sublay reconstruction.</p><p><strong>Material and methods: </strong>This report demonstrates the technique using an illustrative patient case. Developed at Franziskus Hospital Vienna, the procedure combines functional abdominal wall reconstruction with aesthetic optimization. Due to the specific vascular supply of the umbilicus, a precise intraoperative strategy is required to prevent ischemia or necrosis. The report describes the surgical procedure and the anatomical considerations necessary for the safe combination of both techniques.</p><p><strong>Results: </strong>The combination of retromuscular sublay repair and abdominoplasty proved to be safe and feasable. Restoration of abdominal wall integrity and contour was achieved while preserving umbilical viability. No perfusion-related complications occurred. The findings suggest potential improvements in postoperative quality of life.</p><p><strong>Conclusion: </strong>The FRANCIS technique combines functional reconstruction and aesthetic objectives while respecting the vascular anatomy of the umbilicus and represents a promising approach for postpartum patients with umbilical hernia and rectus diastasis.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"727-731"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148058555","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":"[Risk factors for an extended hospital stay after elective minimally invasive colonic surgery in Germany-Data analysis of the StuDoQ register].","authors":"M Kaufmann, S Hetjens, C Klinger, C Reißfelder, Julia Hardt","doi":"10.1007/s00104-026-02510-4","DOIUrl":"10.1007/s00104-026-02510-4","url":null,"abstract":"<p><strong>Introduction: </strong>Within the framework of this analysis the duration of the hospital stay of elective minimally invasive oncological colon resections and sigma resections in cases of sigmoid diverticulitis between 2013 and 2024 from the corresponding StuDoQ registers were investigated. The aim of the analysis was to identify risk factors for an extended duration of the hospital stay.</p><p><strong>Method: </strong>The data from the StuDoQ registers \"Colon cancer\" and \"LapSigma\" were examined. Emergency interventions, open/endoscopic interventions and converted operations were excluded. The shared variables of both registers were age, sex, body mass index (BMI), the American Society of Anesthesiologists (ASA) class, the duration of surgery and the access at the start of surgery. For colon cancer the localization of the tumor, the pT stage, the pN stage and the M status were evaluated in addition to the surgical intervention. For the \"LapSigma\" register the indications for the intervention and the classification were investigated. Univariate and multivariate analyses were carried out.</p><p><strong>Results: </strong>In the \"Colon cancer\" register between 2013-2024 from 52,203 patients 17,930 could be included in the analysis. The median duration of hospital stay was 8 days (IQR 6-11). The multivariate analysis showed that the ASA class (odds ratio 1.44, 95% CI 1.37-1.52, p<0.001) and the M status (odds ratio 1.24, 95% CI 1.24-1.34, p<0.001) were risk factors for a hospital stay lasting longer than 8 days. In the \"LapSigma\" register between 2013 and 2024 there were a total of 33,669 patients of whom 26,324 patients could be included in the analysis. The median duration of hospital stay was 7 days (IQR 6-8). The multivariate analysis showed that the ASA class (odds ratio 1.35, 95% CI 1.29-1.42, p<0.001) and the indications for surgery (odds ratio 1.62, 95% CI 1.53-1.73, p<0.001) had a significant influence on the duration of hospital stay.</p><p><strong>Discussion: </strong>Within the framework of the analysis many of the variables investigated showed a significant effect with a very high number of cases. Under closer examination, particularly for laparoscopic sigma resections for a sigmoid diverticulitis, a higher ASA class and indications for surgery (early elective and elective with bleeding) are decisive for an extended duration of hospital stay. For oncological resections a higher ASA class and a positive M status in particular were shown to be significant risk factors for an extended hospital stay.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"756-764"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038268","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}