Surgery (Oxford, Oxfordshire)最新文献_第2页

Patient monitoring techniques 病人监测技术

Surgery (Oxford, Oxfordshire) Pub Date : 2025-04-01 DOI: 10.1016/j.mpsur.2025.01.006

Jason Gandhi, Iain A. Walker

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Innovations in surgical management of frail elderly adults: an overview of current guidance and recent advances

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2025.01.002

George E Richardson, Francesco Magni, Musa China, Danyal Z Khan, Hani J Marcus

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Clinical entrepreneurship: a driver for digital transformation in surgery

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2025.01.003

Emily C Mills, Grant Nolan, Tony Young

{"title":"Clinical entrepreneurship: a driver for digital transformation in surgery","authors":"Emily C Mills, Grant Nolan, Tony Young","doi":"10.1016/j.mpsur.2025.01.003","DOIUrl":"10.1016/j.mpsur.2025.01.003","url":null,"abstract":"<div><div>Clinical entrepreneurship describes the act of a healthcare professional starting a business with the aim of making a profit. They use their experience to generate sustainable and scalable solutions to healthcare problems. Workforce development programmes, like the NHS Clinical Entrepreneur Programme (NHS CEP), allow innovators to learn the critical business and financial skills required to progress their ideas. Digital transformation is a key area for Clinical Entrepreneurs. Utilizing novel digital technologies, robotics and artificial intelligence, new innovations are set to improve patient outcomes, lower costs, and increase surgical efficiency. This article outlines some of the most exciting areas of digital transformation in surgery. There are numerous challenges facing the adoption of digital innovation in surgery, which include integration with electronic patient record (EPR) systems, legacy infrastructure, variable regulatory, information governance and procurement processes and sometimes conflicting cultural opinions of key decision makers. Clinical entrepreneurship offers a new way to help address these barriers and deliver digital transformation in surgery.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 3","pages":"Pages 135-139"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642006","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}

引用次数: 0

Artificial intelligence in surgery: what is needed for ongoing innovation

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2024.12.005

Vivek Singh, Shubha Vasisht, Daniel A Hashimoto

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How can the model for a sustainable surgical pathway be enhanced by digital medicine?

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2024.12.004

Alyss Vaughan Robinson, Jonathan Noël, Adam Peckham-Cooper, Victoria Pegna

{"title":"How can the model for a sustainable surgical pathway be enhanced by digital medicine?","authors":"Alyss Vaughan Robinson, Jonathan Noël, Adam Peckham-Cooper, Victoria Pegna","doi":"10.1016/j.mpsur.2024.12.004","DOIUrl":"10.1016/j.mpsur.2024.12.004","url":null,"abstract":"<div><div>Climate change is having a significant impact on human health and surgery is a major contributor to greenhouse gas emissions from healthcare. Digital health refers to the use of digital technologies and tools to improve healthcare delivery, enhance health outcomes, and increase the efficiency of healthcare systems. It encompasses a broad range of applications, from mobile health apps and wearable devices to telemedicine, electronic records, and advanced data analytics. These can all be successfully applied to the surgical pathway, reducing the burden on carbon-intensive healthcare systems through minimizing operative risk, enhancing the patient's perioperative experience and modelling sustainable resource use. However, many of these technologies are in their infancy and more evidence is required to ensure that potentially costly technologies and hardware are worthwhile for patients and minimize the environmental impact of surgery. This is particularly relevant to robotic surgery, which is significantly more carbon-intensive than equivalent laparoscopic and open procedures.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 3","pages":"Pages 153-159"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641903","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}

引用次数: 0

Extended reality in surgery – past, present, and future

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2024.12.003

Gao Yujia

{"title":"Extended reality in surgery – past, present, and future","authors":"Gao Yujia","doi":"10.1016/j.mpsur.2024.12.003","DOIUrl":"10.1016/j.mpsur.2024.12.003","url":null,"abstract":"<div><div>Extended reality (XR) technology, encompassing virtual reality (VR), augmented reality (AR), and mixed reality (MR), has evolved significantly in its application to surgery. Initially limited by technical constraints, XR has progressed from basic VR applications in the 1990s to more sophisticated MR systems today. Current applications include advanced surgical training, detailed preoperative planning, intraoperative guidance, and remote surgical assistance. XR offers unique advantages in surgical education, allowing trainees to develop muscle memory while interacting with 3D anatomical models. In surgical planning and navigation, it enables surgeons to visualize complex 3D anatomies directly, potentially improving precision and reducing complications. Remote surgical assistance through XR platforms has shown promise in addressing healthcare disparities. However, the integration of XR in surgery faces several challenges. These include hardware limitations like image resolution and device comfort, software complexities, computing power constraints, and wireless communication issues. Data privacy and security concerns are significant, especially when handling sensitive patient information. Clinical validation remains a hurdle, with a need for standardized evaluation metrics and large-scale trials. User acceptance is also critical, as surgeons must adapt to new technologies and overcome potential resistance to change.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 3","pages":"Pages 140-145"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642010","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}

引用次数: 0

The critical importance of non-technical skills in developing surgical teams in the digital era

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2025.01.005

Umar Rehman, Mohammad Sohaib Sarwar, Steve Jarvis, Rachel S. Oeppen, Peter A. Brennan

{"title":"The critical importance of non-technical skills in developing surgical teams in the digital era","authors":"Umar Rehman, Mohammad Sohaib Sarwar, Steve Jarvis, Rachel S. Oeppen, Peter A. Brennan","doi":"10.1016/j.mpsur.2025.01.005","DOIUrl":"10.1016/j.mpsur.2025.01.005","url":null,"abstract":"<div><div>Human errors are common in both personal and professional settings. Human factors encompass how individuals and teams interact with each other, their environment, and technology. Fatigue, hydration, nutrition, and stress significantly impact surgical performance and patient safety. Regular breaks, proper hydration, balanced nutrition, and stress management enhance cognitive function and team dynamics, thereby reducing errors. Surgical technology including robot-assisted surgery, presents unique challenges that can increase the propensity of error, particularly in communication. This necessitates further system and workplace optimization to minimize risks. Digital technology helps reduce medical errors and ensures prompt access to senior support. Platforms like WhatsApp enable trainees to quickly contact consultants, thus enhancing patient safety. This strategy is associated with reduced workload, improved trainee support and reliable imaging review. However, compliance with data protection and information governance is crucial and further work may be required to develop secure platforms that maintain confidentiality and data safety. This review examines the prevalence of medical errors and delves into factors and strategies to mitigate them, thereby enhancing teamwork and patient safety.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 3","pages":"Pages 171-177"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641906","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}

引用次数: 0

Making the most of clinical fellowships – robotics, data science and artificial intelligence

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2025.01.004

Luis Ribeiro, Nicholas Raison

{"title":"Making the most of clinical fellowships – robotics, data science and artificial intelligence","authors":"Luis Ribeiro, Nicholas Raison","doi":"10.1016/j.mpsur.2025.01.004","DOIUrl":"10.1016/j.mpsur.2025.01.004","url":null,"abstract":"<div><div>The rapid advancement of surgical technologies, including robotics, data science and artificial intelligence (AI), has created a widening gap between the skills required by modern surgeons and the offerings of traditional training programmes. Historically, this gap led to the development of specialized clinical fellowships, which have now become essential for surgeons seeking to master these emerging technologies. Robotic surgery and AI demand new competencies, yet these are not fully integrated into current surgical curricula. Fellowships in robotic surgery and digital health offer structured, hands-on training, combining theoretical knowledge with practical application. Integration of AI with robotics has shown significant promise in improving intraoperative performance and surgical education. Digital fellowships, such as the Topol Digital Fellowship and NHS Clinical AI Fellowship, focus on developing leadership in digital transformation within healthcare, equipping surgeons with skills in data analysis, machine learning, and AI applications. As surgery becomes increasingly intertwined with data science and AI, these fellowships are not only addressing current educational gaps but also paving the way for a technologically adept surgical workforce, capable of leveraging advanced technologies to enhance patient care.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 3","pages":"Pages 166-170"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641905","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}

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Test yourself: MCQ and single best answer

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2025.01.012

Adrian Ben Cresswell

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The impact of cancer genomics across the surgical pathway

Surgery (Oxford, Oxfordshire) Pub Date : 2025-03-01 DOI: 10.1016/j.mpsur.2025.02.001

Adam C. Chambers, Frank D. McDermott

{"title":"The impact of cancer genomics across the surgical pathway","authors":"Adam C. Chambers, Frank D. McDermott","doi":"10.1016/j.mpsur.2025.02.001","DOIUrl":"10.1016/j.mpsur.2025.02.001","url":null,"abstract":"<div><div>The human genome is comprised of 3 billion base pairs and understanding genomics is crucial for providing modern surgical care. Variants (mutations) in DNA can predispose to disease. Cancer genomes are heterogeneous, and a tumour is often comprised of multiple different clones of cells (tumour heterogeneity). Genomics has implications for screening, diagnostics, pharmacogenomics, identifying minimal residual disease (MRD) and monitoring disease. Testing in NHS England is performed by seven genomic laboratory hubs that provide testing for rare disease and cancers. Testing includes single gene tests, gene panels, whole exome sequencing (WES – coding genes only) and whole genome sequencing (WGS). Circulating tumour DNA (ctDNA) is being used as a diagnostic tool in non-small cell lung cancer and is being used more widely for other cancer indications including monitoring of disease to personalize chemotherapy choice based on the tumours' molecular profile. Cancer vaccines are a type of immunotherapy that can prime the immune system to identify cancer cells and destroy them. The BNT122-01 colorectal cancer study, for example, uses an mRNA vaccine that is bespoke to a patient's tumour (patients that are ctDNA positive and are receiving adjuvant chemotherapy). Surgical teams need to be educated and up-skilled in the use of these new technologies to personalize care and improve outcomes.</div></div>","PeriodicalId":74889,"journal":{"name":"Surgery (Oxford, Oxfordshire)","volume":"43 3","pages":"Pages 146-152"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143642011","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}

引用次数: 0