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Feasibility and Safety of Single-Incision Robotic Assisted Colorectal Surgery

In a nonrandomized cohort pilot study, researchers explored the feasibility and safety of single-incision robotic-assisted surgery (SIRAS) using the Shurui Endoscopic Surgical Robotic System (SR-ENS-600). Seven patients underwent successful SIRAS for colorectal malignancy. The SR-ENS-600 platform exhibited preferable maneuverability/stability in confined fields. Although one case encountered intraoperative hemorrhage, overall outcomes were satisfactory, with no short-term complications or mortality. While affirming SIRAS feasibility, larger investigations are crucial for establishing safety and superiority in selected patients.

Journal Article by Guo Z, Shi Y (…) Zhao R et 8 al. in Int J Surg

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Storage Time of Transfused Red Blood Cells and Postoperative Infections in Clean-Contaminated Surgery

Investigating the impact of red blood cell storage time on postoperative infections in clean-contaminated surgery, a cohort study with 4,046 patients revealed no significant association between prolonged storage time and increased infection risk. Analyzing 11,604 transfusion episodes, even after adjusting for 17 confounders, no notable correlation was found in either episode-level or patient-level analysis. This suggests that, within the studied parameters, storage time of transfused red blood cells does not significantly contribute to higher infection risks post-surgery.

Journal Article by Xu X, Zhang Y (…) Huang Y et 3 al. in Ann Surg

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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Global Benchmarks for Robotic Bariatric Surgery

A comprehensive study across 17 centers on four continents, comparing robotic bariatric surgery with laparoscopic benchmarks, involved 9,097 patients. In expert centers, robotic Roux-en-Y gastric bypass demonstrated lower benchmark cut-offs for hospital stay, bleeding, and ulceration but had a longer operation duration. Robotic sleeve gastrectomy outperformed its laparoscopic counterpart in most outcomes. Overall, newly established benchmarks suggest enhanced safety in robotic bariatric surgery compared to laparoscopic, despite longer operation times for certain procedures.

Journal Article by Giudicelli G, Gero D (…) Jung MK et 38 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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Combined Hepatocholangiocarcinoma: Worse Survival Than Hepatocellular Carcinoma, Similar to Intrahepatic Cholangiocarcinoma

In a retrospective study of 3,196 surgery-treated patients with combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma, survival outcomes were analyzed. Despite data limitations, overall survival for combined hepatocholangiocarcinoma was worse than hepatocellular carcinoma but similar to intrahepatic cholangiocarcinoma. Disease-free survival was comparable among the three groups. Predictors of mortality included the cancer subtype, metabolic syndrome, preoperative tumor markers, and satellite nodules, while recurrence was associated with satellite nodules rather than cancer subtype. The study suggests the need for future research on immunophenotypic profiling for better predictive capabilities.

Journal Article by Amory B, Goumard C (…) Brustia R et 31 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Appendectomy vs. Hemicolectomy for 1- to 2-cm Appendix Neuroendocrine Tumors: A Survival Analysis

Examining 3,189 patients with 1- to 2-cm neuroendocrine tumors of the appendix, researchers found that while the appendectomy rate increased over the years, it wasn’t linked to improved survival compared to right hemicolectomy. Grade 2 and 3 tumors were associated with a lower likelihood of appendectomy. Despite differences in tumor grades and patient travel distance, overall survival after appendectomy was similar to hemicolectomy. The study questions the routine use of hemicolectomy for these tumors, suggesting that it may not enhance treatment outcomes.

Journal Article by Ahmed FA, Wu VS (…) Hoehn RS et 5 al. in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Prophylactic Negative Pressure Wound Therapy in Emergency Laparotomy: No Significant Reduction in Surgical Site Infections

Examining 65,803 emergency laparotomy patients, researchers found no significant difference in surgical site infection (SSI) rates when comparing prophylactic negative pressure wound therapy (NPWT) to standard dressings. Propensity-matched cohorts with completely or partially closed incisions showed similar SSI rates (13.4% vs. 11.9% and 3.6% vs. 4.4%, respectively). Secondary outcomes, including postoperative complications and hospital length of stay, did not significantly differ between NPWT and standard dressing groups, suggesting no substantial benefit in reducing SSIs with prophylactic NPWT.

Journal Article by Rafaqat W, Proaño Zamudio JA (…) Hwabejire JO et 7 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Objective Hiatal Hernia Sizing: Enhancing Precision in Surgical Decision-Making

Investigating hiatal hernia (HH) size reporting, researchers compared subjective estimates with objective axial length measurements in 93 patients. While endoscopic subjective size allocations correlated with intra-operative decisions, axial length measurements significantly correlated with manometry results. Only one barium swallow report included an objective HH size measurement. Integrating axial length measurements into endoscopy reports is crucial, enhancing outcome precision and informing clinical decisions, emphasizing the need to move beyond subjective terms in HH characterization.

Journal Article by Palenzuela DL, Gee D (…) Paranjape C et 3 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Mitigating Laparoscopic Gas Leaks: A Clinical Trial with Optical Imaging and a Novel Vacuum-Ring Device

In a clinical trial, researchers utilized optical gas imaging to detect laparoscopic gas leaks during surgeries and tested a vacuum-ring device’s effectiveness in mitigating leaks. Among 1643 trocar instrumentations, leaks occurred in 62.6% of visualized instances. The intervention group, using the vacuum-ring device, showed a significant reduction in high-energy leaks (Class 3) compared to the control group. The study demonstrates that available technology, including optical imaging and the vacuum-ring device, can sensitively detect and effectively mitigate laparoscopic gas leaks.

Journal Article by Nolan K, Khan MF (…) Cahill RA et 6 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Mentorship-Based Clerkship Boosts Student Confidence and Interest

A Mentorship-Based Surgery Clerkship (MBSC) significantly enhances medical students’ surgical experiences, confidence, and perceptions. In a nonrandomized trial with 84 participants, MBSC students reported increased confidence in surgical skills, positive perceptions of surgeons, and greater interest in pursuing surgery compared to the non-mentored group. The innovative program positively impacted students’ perceived meaningfulness, surgeon qualities, and career considerations, highlighting the effectiveness of mentorship in surgical education.

Journal Article by Joel M, Iosif L, Grenda T and Tholey R in J Surg Res

Published by Elsevier Inc.

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US Hepatopancreatobiliary Surgeon Supply Surpasses Demand

Examining 1998-2019 data, this study unveils a potential surplus in the supply of hepatopancreatobiliary (HPB) surgeons in the US. In 2019, 37,335 inpatient HPB procedures occurred, with an estimated 905-1191 practicing HPB surgeons. Factoring in centralization and volume-outcome benchmarks, the study projects a possible oversupply by 2030. Without adjustments, the data suggests a risk of insufficient case volume per HPB surgeon, challenging the maintenance of optimal volume-outcome standards in the near future.

Journal Article by Rengers T, Ubl D (…) Warner SG et 3 al. in HPB (Oxford)

Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

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