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Robotic Liver Surgery Complexity Scores Validated

Surgeons now have a new, validated tool to assess the complexity of robotic liver surgery, improving patient selection and outcomes.

  • The International RoboLiver Difficulty Scoring System outperformed the Southampton model with an AUC of 0.719, indicating better prediction of intraoperative complications.
  • Key predictors of prolonged operative time include neoadjuvant chemotherapy, lesion size >50 mm, and bilobar disease.

This tool aids in preoperative planning and enhances operational efficiency in robotic liver procedures.

Journal Article by El Adel S, Pilz da Cunha G (…) Abu Hilal M et 24 al. in J Am Coll Surg

Copyright © 2026 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Diabetes Status Matters for Surgical Risk Assessment

Elective surgeries may carry different risks based on patients’ glycemic status rather than just diabetes diagnosis.

  • In a study of over 2 million hospitalizations, 9.16% of patients with diabetes and hyperglycemia had major adverse events, compared to 5.31% without diabetes.
  • Patients with diabetes without hyperglycemia had a modest increased risk (5.85%) with a number needed to harm of 183.
  • Clinically recognized hyperglycemia significantly increases perioperative risk (aOR 2.00) and should be prioritized in risk stratification for elective surgeries.

Journal Article by Kim S, Saad B (…) Wong MS et 2 al. in J Am Coll Surg

Copyright © 2026 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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Delayed Closure in Colorectal Surgery May Not Cut Infections

Delayed primary closure with intrawound irrigation doesn’t reduce surgical site infections after colorectal perforation.

  • Superficial and deep SSI rates: 25% for delayed closure vs. 50% for primary closure.
  • ICU and hospital stays were longer for delayed primary closure.

Surgeons should weigh the benefits of reduced infection risk against potential longer recovery times.

  • Findings need confirmation in larger studies for more definitive guidance.

Journal Article by Ogawa K, Karashima R (…) Takamori H et 5 al. in Am J Surg

Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.

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Pelvic MRI is unreliable post-neoadjuvant therapy for rectal cancer.

  • 40% of patients with a complete clinical response (CCR) endoscopically had residual disease on MRI.
  • After a mean follow-up of 4.8 years, 30% had disease regrowth, with no significant difference in rates based on MRI results (33% vs. 27.8%).

Surgeons should be cautious in relying solely on MRI for treatment decisions following total neoadjuvant therapy, as endoscopic CCR does not guarantee a lack of disease.

  • 67% of patients with positive MRI findings did not experience regrowth after 4 years.

Journal Article by Suss NR, Johnson R (…) Shogan BD et 4 al. in J Surg Oncol

© 2026 Wiley Periodicals LLC.

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Robotic Pancreatoduodenectomy in Octogenarians Offers Advantages

Robotic pancreatoduodenectomy in patients 80 and older shows significant benefits over open surgery.

  • Operative time was longer for robotic (441 min) vs. open (375 min), but with less blood loss (266 ml vs. 565 ml).
  • Postoperative complications were lower with robotic surgery (52.2% vs. 70.6% for open, p = .013) as well as rates of pancreatic fistula (9.3% vs. 29.4%, p < .001).

Robotic surgery may be a safer option for surgical candidates in this age group when performed in experienced centers.

  • Average hospital stay was shorter after robotic surgery (13 days vs. 21 days, p = .002).

Journal Article by Marchese T, Valle V (…) Morelli L et 5 al. in BMC Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Surgeons Improve Antibiotic Use with Education

Surgeons can significantly enhance antimicrobial prescribing practices through targeted education, tackling the critical issue of antibiotic misuse.

  • Educational interventions led to better antibiotic selection, timing, and duration.
  • Review included 17 studies, primarily from high-income, tertiary hospitals, emphasizing pre-post design effectiveness.

These findings underscore the importance of implementing educational strategies to strengthen antimicrobial stewardship in surgical practices.

  • Multimodal approaches, such as lectures and guidelines, were notably effective in achieving these improvements.

Review by Laor B, Hassan AS, Gold MS and Girsowicz E in Am J Surg

Copyright © 2026 The Authors. Published by Elsevier Inc. All rights reserved.

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Mentorship Programs Increase Diversity in Surgery

Surgical subspecialties are striving for greater diversity through targeted mentorship for underrepresented minorities.

  • Only 18 of 255 studies highlighted programs for URIM students, mainly at medical school (11) and high school (3) levels.
  • Outreach can effectively boost interest in surgery among URIM individuals, though vascular surgery lacks any dedicated programs.

Increasing mentorship initiatives across all levels and subspecialties is crucial for improving diversity in the surgical workforce.

Review by Falzarano CE, Khalil SK, Mellman TA and Levy G in Am J Surg

Copyright © 2026 Elsevier Inc. All rights reserved.

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Redefining Surgical Education with a Virtual Journal Club

A novel journal club enhances resident training and engagement in trauma surgery.

  • Residents improved critical appraisal skills and public speaking abilities.
  • Faculty valued direct interactions with study authors on methodology and clinical relevance.

This low-resource model fosters meaningful discussions without the logistical burdens of in-person events.

  • Participating experts gained visibility and scholarly dissemination with minimal time investment.

Journal Article by Simon EF, Kramer C (…) Posluszny J et 3 al. in J Surg Res

Copyright © 2026 Elsevier Inc. All rights reserved.

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Enhancing Liver Surgery Training: Outcomes from a Leading Fellowship

Dedicated hepatobiliary fellowship programs sharply boost surgical confidence and competence, crucial for today’s complex liver surgeries.

  • Fellows showed a confidence jump from 2.5 to 9 out of 10 in performing right hemihepatectomies after training.
  • Median surgical volume included 65 liver resections, with minimally invasive exposure rising from 10 to over 20 cases in five years.

Over 80% of fellows published research, and 83% secured consultant positions within a year.

Programs must integrate robotic surgery training to remain relevant as techniques evolve.

Journal Article by Wettstein D, Primavesi F (…) Diaz-Nieto R et 20 al. in Eur J Surg Oncol

Copyright © 2026. Published by Elsevier Ltd.

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Global Consensus on Managing Gastric Cancer Peritoneal Metastasis

Experts established clear guidelines for handling gastric cancer with peritoneal metastasis, crucial for improving patient outcomes.

  • Consensus reached on 13 statements regarding diagnosis and treatment, with 75-100% agreement among 42 experts.
  • A broader expert group, including medical oncologists, showed 12 of 13 statements agreed upon but struggled with systemic treatment consensus (52%).

These guidelines aim to standardize care and spotlight urgent research needs in this complex area.

Consensus Statement by Boshier PR, Chia DKA (…) So JBY et 40 al. in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.
© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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