Chirurgie (Heidelberg, Germany)最新文献

{"title":"[Development and implementation of a structured training program in robotic surgery : The first step is always the hardest].","authors":"Sarah Englert, Natascha Tschukewitsch, Alexa Wölfl, Christoph Justinger","doi":"10.1007/s00104-025-02304-0","DOIUrl":"10.1007/s00104-025-02304-0","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted surgery has become increasingly important in Germany in recent years. In addition to urology, it is becoming standard in visceral surgery and gynaecology. In many centres, robotic surgery appears to be competing with the training of young surgeons, as experienced surgeons have often been trained in robotics with the support of industry. The continuous expansion of robot-assisted surgery requires an increasing implementation in medical training. Here we present a structured training concept for learning robotic surgery for advanced residents and young surgical specialists.</p><p><strong>Materials and methods: </strong>A structured training program was developed with the aim of teaching robotic surgery to advanced residents. Candidates undergo training units that build on each other during ongoing operations. Supplemented by predefined theoretical teaching content and video training, the trainees develop a basic understanding of the surgical method. The modular nature of the program allows participants to learn from each other.</p><p><strong>Results: </strong>By establishing a structured training concept, it is possible to introduce advanced residents to robotic surgery. The planned completion of various training steps not only increases the team's acceptance of the surgical method, but also develops a fundamental understanding of the strengths and challenges of robotic surgery. Overall, the strong standardization of the training increases the clinic's level of competence in robotic surgery.</p><p><strong>Conclusions: </strong>The increasing spread of robotic surgery necessitates an expansion in the training of surgical residents. By establishing a structured training curriculum, it is possible to introduce advanced residents to robotics.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"765-773"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276918","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":"[Anal cancer-Interaction between outpatient and inpatient treatment].","authors":"Stefan Fritz, Arne Mathias Ruder, Dieter Bussen, Christoph Reißfelder, Julia Hardt","doi":"10.1007/s00104-025-02337-5","DOIUrl":"10.1007/s00104-025-02337-5","url":null,"abstract":"<p><strong>Background: </strong>Anal cancer is a rare but increasingly more frequently diagnosed entity. The treatment mostly consists of a combination of surgery and/or combined radiotherapy/chemotherapy. In advanced cases, extensive visceral resection may be necessary. In most cases, treatment is interdisciplinary and includes both outpatient and inpatient treatment phases.</p><p><strong>Objective: </strong>The aim of this work is to shed light on the most important steps in the diagnostics and treatment of anal cancer with a focus on the interaction between outpatient and inpatient patient care.</p><p><strong>Material and methods: </strong>To determine the evidence base for this article, a literature search was conducted in the PubMed database. In addition, the current guidelines and recommendations were included.</p><p><strong>Results: </strong>Outpatient facilities are often responsible for initial diagnostics and follow-up care, while inpatient facilities are responsible for implementing the complex treatment measures. This interaction presents challenges, particularly in coordinating treatment processes, communicating relevant information and adhering to time schedules. Delays in the referral or follow-up care can lead to a worsening of the prognosis.</p><p><strong>Conclusion: </strong>Multimodal and interdisciplinary treatment is essential for the successful treatment of anal cancer. Cross-sectoral cooperation between outpatient and inpatient care plays a central role. This is the only way to ensure the best possible oncological treatment while maintaining the quality of life.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"743-750"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512881","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":"[Sudden chest pain after thoracotomy].","authors":"Ludwig Rauch, Thomas Händl","doi":"10.1007/s00104-025-02311-1","DOIUrl":"10.1007/s00104-025-02311-1","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"774-778"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112931","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":"[Is the application of digital technologies the game changer for surgical training of the future? A Germany-wide analysis].","authors":"Dolores T Krauss, Hans F Fuchs, Sebastian Schaaf, Sabine Drossard, Romina Rösch, Beate Blank, Christiane J Bruns, Udo Rolle, Thomas Schmitz-Rixen, Juliane Kröplin","doi":"10.1007/s00104-025-02306-y","DOIUrl":"10.1007/s00104-025-02306-y","url":null,"abstract":"<p><strong>Background: </strong>The use of digital technologies is becoming increasingly important in medicine and is having a significant impact on developments in the surgical field. However, there is a great need to improve and implement those new techniques in surgical education and training in order to adequately prepare young surgeons for associated challenges.</p><p><strong>Objectives: </strong>The aim of this study is to analyze the importance, use, and influence of digital technology on the success of future surgical training in Germany.</p><p><strong>Materials and methods: </strong>An online survey was conducted from April-September 2024 with a total of 12 open (n = 2) and standardized (n = 10) questions. The closed questions could be answered on a Likert scale from 1 (strongly agree) to 5 (strongly disagree). The questionnaire was sent out via the email distribution list of the German Society of Surgery and its social media channels.</p><p><strong>Results: </strong>A total of 97 response datasets were analyzed. At the time of analysis, the majority of participants were working in general surgery (n = 54, 64%) and at a nonuniversity clinic (n = 49, 58%). In all, 19% of the respondents were residents. When choosing their current workplace, 44% prioritized advanced digitalization, while 61% stated that they had not yet used generative AI at all. Only 9% of trainees had access to curricular training on robotic systems. A change to a location with more advanced medical technology was considered by 19%. While 26% of study participants would consider being operated on by an AI-assisted robotic system, 46% of the participants could imagine using this technology on their patients.</p><p><strong>Conclusion: </strong>This analysis provides insight into the importance and use of digital technology in surgery in Germany. In particular, it reveals deficits in the use of AI-based methods, comprehensive provision of digital technologies, and the access of trainees to innovative training. The results also confirm the need to further raise awareness of the topic.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"755-764"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12370858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121539","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":"[Operative treatment of recurrent inguinal hernias after endoscopic pre-operation using the TEP technique (RE-TEP)].","authors":"Friedrich Mainik, Orhan Tapkiran, Niklas Hoffer, Andreas Kuthe","doi":"10.1007/s00104-025-02349-1","DOIUrl":"https://doi.org/10.1007/s00104-025-02349-1","url":null,"abstract":"<p><strong>Background: </strong>Recurrence and reoperation rates as well as intraoperative and postoperative complications are much higher in the treatment of inguinal hernia recurrences than in the treatment of primary hernias and increase with each additional follow-up procedure. Is endoscopic treatment of endoscopically pre-operated patients an alternative technique?</p><p><strong>Aim of the study: </strong>Retrospective case study analysis on the feasibility of treating recurrent inguinal hernias after initial endoscopic, i.e., total extraperitoneal patch (TEP) or transabdominal preperitoneal (TAPP) repair technique, pre-operation using the TEP technique (RE-TEP) based on data from our own patient collective.</p><p><strong>Material and methods: </strong>Since 2016 a total of 79 patients with recurrences after minimally invasive surgery (MIS) hernioplasty were operated on using the RE-TEP technique. In 30 patients, perioperative data and the results of clinical and sonographic follow-up examinations were evaluated and analyzed, particularly with respect to the quality of life.</p><p><strong>Results and discussion: </strong>Perioperative and postoperative data and results were comparable to those of primary hernia repair. There were no conversions, no intraoperative or postoperative complications, no re-operations or evidence of recurrence with good postoperative quality of life. We were thus able to demonstrate feasibility in a larger group and confirm the results of individual publications of smaller studies.</p><p><strong>Conclusion: </strong>The RE-TEP technique can be seen as an option for the treatment of recurrent inguinal hernias after primary MIS techniques.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980817","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":"Erratum zu: Bürokratielast in der Chirurgie.","authors":"Friederike Burgdorf, C Kunze, B Braun, D Richardt, H-J Meyer, T Auhuber","doi":"10.1007/s00104-025-02376-y","DOIUrl":"https://doi.org/10.1007/s00104-025-02376-y","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980870","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":"[Translational challenges and clinical potential of artificial intelligence in minimally invasive surgery].","authors":"Matthias Carstens, Micha Pfeiffer, Stefanie Speidel, Marius Distler, Jürgen Weitz, Fiona R Kolbinger","doi":"10.1007/s00104-025-02366-0","DOIUrl":"https://doi.org/10.1007/s00104-025-02366-0","url":null,"abstract":"<p><p>Artificial intelligence (AI) holds great potential for minimally invasive surgery, with fields of application ranging from interdisciplinary treatment stratification through preoperative planning up to active decision support in the operating room, which are the focus of this article. Artificial neural networks for analysis of surgical video recordings could enhance surgical safety, efficiency and planning. High-quality, diverse (meta)data are essential for such AI applications but the annotation, training and validation present complex demands. Despite technological advances, the clinical implementation often fails due to a lack of data standardization, insufficient infrastructure, regulatory barriers and ethical uncertainties. Many models remain black boxes, which hinders acceptance and trust among medical professionals. In addition, AI systems need to be robust, transparent and practically integrable into clinical workflows. Stringent data collection strategies, privacy-preserving learning methods, explainable AI and human-in-the-loop approaches are critical to facilitate clinical translation. Regulatory framework conditions, such as the General Data Protection Regulation, the EU Medical Device Regulation and the EU AI Act, will require further legal refinements to address the specific needs of medical AI applications and interventions, to facilitate the safe adoption of interdisciplinary assistive technologies in the operating room that meaningfully support surgical practice.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144980906","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 management of giant hemangiomas in the caudate lobe: an overview on the intraoperative management and role of artificial intelligence (AI) in improvement of the surgical results].","authors":"Sofia Rozani, Georg Weber, Robert Grützmann","doi":"10.1007/s00104-025-02361-5","DOIUrl":"https://doi.org/10.1007/s00104-025-02361-5","url":null,"abstract":"<p><p>The treatment of giant hemangiomas of the caudate lobe remains a major challenge due to the complex anatomy and the proximity of the caudate lobe to important vascular structures. Recent progress in the field of artificial intelligence (AI) has introduced new paradigms for the preoperative planning, intraoperative navigation and postoperative care. This overview demonstrates how AI-guided technologies can improve the surgical precision, minimize complications and ultimately improve the results for patients who undergo a resection of giant hemangiomas in the caudate lobe.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823323","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":"[Burden of bureaucracy in surgery : Results of a national survey].","authors":"Friederike Burgdorf, C Kunze, B Braun, D Richardt, H-J Meyer, T Auhuber","doi":"10.1007/s00104-025-02340-w","DOIUrl":"10.1007/s00104-025-02340-w","url":null,"abstract":"<p><strong>Background: </strong>Bureaucratic tasks in everyday surgical clinical practice are time-consuming. Due to the increasing shortage of skilled workers and the growing need for care, it is necessary to relieve surgeons of administrative tasks.</p><p><strong>Objective: </strong>The analysis aims to make the nature and extent of administrative tasks transparent in order to derive options for action.</p><p><strong>Material and methods: </strong>Data were collected as a survey using a digital questionnaire with 29 questions.</p><p><strong>Results: </strong>1632 BDC members participated in the survey with a response rate of 19%. The survey results illustrate that surgeons manage a particularly high workload and 82% of full-time employees reported working an average of 49-79 h per week. The proportion of bureaucratic tasks proved to be high, with 3-4 h per day according to 67% of full-time employees. While 94% of full-time employees stated that around 1-3 h of bureaucratic work should be delegated daily but only 42% are authorized to delegate bureaucratic tasks. Redundant documentation arises primarily from the need for duplicate documentation of identical data, audits by the medical service as well as quality audits. 88% of respondents rated the benefit of information technology in reducing the documentation burden as relatively low or minimal.</p><p><strong>Discussion: </strong>The results fit into the context of other recent surveys on the burden of bureaucracy.</p><p><strong>Conclusion: </strong>To improve the situation, legislators, partners in joint self-government and hospital management have a duty to reduce documentation requirements, optimize processes and improve opportunities for electronic data exchange.</p>","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144801083","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":"[Active surveillance versus surgery after neoadjuvant chemoradiotherapy-Results of the SANO trial].","authors":"L M Schiffmann, C J Bruns","doi":"10.1007/s00104-025-02332-w","DOIUrl":"10.1007/s00104-025-02332-w","url":null,"abstract":"","PeriodicalId":72588,"journal":{"name":"Chirurgie (Heidelberg, Germany)","volume":" ","pages":"685-686"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334507","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}