Routine Surgical Practice Research Articles

Morel–Lavallee Lesion of the Hip in Children: About a Case and Literature Review

ABSTRACT Morel–Lavallée lesion, also called closed degloving injury, is a rare clinical entity in routine pediatric surgical practice. We present a case of an 11-year-old girl presenting with a left hip lesion, treated with compression bandage, and the clinical outcome was favorable.

Ultrasound-guided cryoablation of early breast cancer: safety, technical efficacy, patients' satisfaction, and outcome prediction with MRI/CEM: a pilot case-control study.

This pilot prospective study aimed to evaluate ultrasound-guided cryoablation of breast cancer (BC) by assessing: (i) technical efficacy as the presence of necrosis in surgical specimens and rate of complete tumor ablation; (ii) safety as incidence and severity of complications; and (iii) patients' satisfaction using a dedicated questionnaire. In addition, (iv) we tested the capability of magnetic resonance imaging (MRI) or contrast-enhanced mammography (CEM) to predict cryoablation efficacy. From 07/2022 to 01/2023, we enrolled 20 patients with early-stage BC scheduled for breast surgery. Ten of them, with a cryo-feasible cancer location, were sent to cryoablation (cryo-group) and ten to routine surgical practice (control group). Both groups underwent surgery and were asked to answer a satisfaction questionnaire. Of eleven patients screened for cryoablation, only one refused to be treated at another hospital (acceptance rate 10/11, 91%). Surgery was quadrantectomy in 19 cases and mastectomy in 1. In the cryo-group, the procedure was completed and steatonecrosis was observed in 10/10 cases, with complete tumor ablation in nine of them. The post-procedural status was evaluated with MRI in five patients, with CEM in four patients, and with ultrasound in one patient who refused MRI and CEM. MRI or CEM correctly predicted complete cryoablation in eight patients and incomplete cryoablation in one patient. Patients in both groups did not have serious complications and responded positively to satisfaction questionnaires. Ultrasound-guided cryoablation of early-stage BC is well accepted by patients, effective, and safe. MRI and CEM were able to predict the procedure's technical efficacy. https://clinicaltrials.gov/study/NCT05727813 updated February 14, 2023. Our pilot study showed that ultrasound-guided cryoablation is a promising nonsurgical alternative for treating early-stage BC. Ultrasound-guided cryoablation was effective and safe in early BC patients. The procedure was well-tolerated, with low morbidity and high patient satisfaction. MRI and CEM predicted cryoablation efficacy, in accordance with histopathologic findings. Cryoablation can be considered a potential alternative to surgery in selected patients.

Anatomical and Developmental Abnormalities of Ureters and Renal Pelvis Existing with Accessory Renal Arteries: Cadaveric Study.

Anatomical and developmental variations of ureters and renal pelvis have been observed frequently during routine human cadaveric dissection and surgical practice; however, their coexistence with accessory or aberrant renal arteries is exceptionally rare. Accordingly, this study was designed to evaluate the prevalence of anatomical and developmental abnormalities of ureters and renal pelvis existing with accessory renal arteries in human cadavers. This study was carried out on 50 human cadavers including dissected specimens (25 males and 25 females) the kidneys, renal pelvis, and ureters along with their arteries were exposed and the anomalous abnormalities of the renal pelvis and ureters existing with accessory renal arteries were observed. Photographs of the anomalous and developmental variations were taken for proper documentation. Among the 50 cadavers studied, unilateral double ureters were found in 5 cadavers (10%), rare bilateral "S-"shaped loop of ureter with quadruple uretic constrictors in the abdominal segment of the ureter was observed in one female cadaver (2%), accessory or aberrant renal arteries were found in 15 cadavers (30%), hydronephrosis involving the renal pelvis and ureters was observed in 9 cadavers (18%). Interestingly, this prevalence was higher among males (28%) compared to females (8%). Moreover, the occurrence of bilateral hydronephrosis of the kidneys, renal pelvis, and ureters was identified in a single male cadaver, representing 2% of the sample. Notably, the prevalence of double ureter, hydronephrosis accompanied by congenital double and triple accessory renal arteries was documented in nine cadavers, accounting for 18% of the cohort. Anatomical and developmental variations of the ureters, renal pelvis, and renal vasculature, as well as their relationships to surrounding structures, hold clinical significance due to their impact on various surgical procedures, including kidney transplantation, abdominal aorta reconstruction, interventional radiology, and urologic operations. Therefore, identifying these potential developmental variations is essential for effective surgical management to preserve renal function and ensure optimal patient outcomes.

Fastening the Future: Surgical Zip Ties for Enhanced Wound Closure and Patient Well-Being

Surgical zip tie skin closures are emerging as a revolutionary approach in wound management, promising significant advancements in patient safety and surgical success. Current research emphasizes the efficacy of zip tie closures in promoting wound healing, reducing the risk of dehiscence, and enhancing cosmetic outcomes across various surgical procedures. Compared to traditional suturing techniques, zip tie closures offer secure wound approximation, minimize tension on wound edges, and contribute to faster recovery times with lower incidences of infection and scarring. Case studies and clinical trials demonstrate the effectiveness of these closures, emphasizing their role in improving surgical outcomes. Future investigations should focus on optimizing zip tie design and material properties to ensure compatibility with different skin types and surgical sites. Innovations in biodegradable and antimicrobial materials could further enhance the utility and applications of zip ties. The potential for using zip tie closures in minimally invasive and robotic-assisted surgeries offers precision and ease of use in complex procedures. Multidisciplinary collaboration between surgeons, engineers, and biomaterial scientists is essential for refining zip tie closure systems, conducting clinical trials, and establishing standardized protocols for integration into routine surgical practice. Addressing challenges related to material biocompatibility, mechanical strength, and user ergonomics will be essential for navigating challenges and limitations. Ultimately, the adoption of surgical zip tie skin closures has the potential to revolutionize wound management and improve patient care, setting new standards in surgical care through innovation and evidence-based practice.

Prognostic role of tumor budding in oral squamous cell carcinoma: a retrospective study

Background Tumor budding is defined as a single cell or a cluster of up to five tumor cells at the invasion front of all oral squamous cell carcinoma (OSCC) cases. Tumor budding is considered as a marker of many important events in oral carcinoma, including the epithelial-mesenchymal transition, invasion, metastasis, and for further prognosis. Methods A total of 30 clinically and histopathologically diagnosed cases of OSCC were retrieved from the archival of the Department of Oral Pathology and Microbiology. After assessing the sections for the presence of tumor budding (TB), it is further categorized into high-intensity TB and low-intensity TB. Results We found a strong association between lymph node metastasis and histopathological grading in the current study. There was no association between TB and a patient’s survival rate. Conclusions This study emphasizes the significance of tumor budding, its relevance to prognosis, and reproducibility, as well as the significance of its evaluation and incorporation into routine surgical pathology practice in the management of OSCC. As a result, we believe that tumor budding is a crucial factor in determining tumor behavior.

The peritoneal cancer index as a predictor of complete cytoreduction at primary and interval cytoreductive surgery in advanced ovarian cancer

ObjectiveThe peritoneal cancer index quantitatively assesses cancer distribution and tumor burden in the peritoneal cavity. The aim of this study is to evaluate the association between the peritoneal cancer index...

Platelet-rich plasma in surgical practice: a review

The use of platelet-rich plasma (PRP) in clinical settings is a current issue in various fields of medicine. There is no unified and structured approach to PRP preparation and application stages. This review examines the literature data on the use of PRP in surgical practice. Data were analyzed using scientific sources from scientific citation platforms, such as RSCI, PubMed, Scopus, and Web of Science. This review describes the most commonly used methods and techniques for preparing PRP in laboratory and experimental conditions. Using data from clinical and experimental studies, the possibility and effectiveness of using PRP in routine and experimental surgical practice were analyzed. PRP has relatively wide range of applications in various areas of clinical medicine; however, its use in pediatric surgical practice requires further study, including the development of indications and contraindications.

Prognostic role of tumor budding in oral squamous cell carcinoma: a retrospective study

Background: Tumor budding (TB) is defined as a single cell or a cluster of up to five tumor cells at the invasion front of all oral squamous cell carcinoma (OSCC) cases. Tumor budding is considered a marker of many important events in oral carcinoma, including the epithelial-mesenchymal transition, invasion, metastasis, and for further prognosis. Methods: A total of 30 clinically and histopathologically diagnosed cases of OSCC were retrieved from the archival of the Department of Oral Pathology and Microbiology. After assessing the sections for the presence of TB, it is further categorized into high-intensity TB and low-intensity TB. Results: We found a strong association between lymph node metastasis, lymph node metastasis, and histopathological grading in the current study. There was no association between TB and a patient's survival rate. Conclusions: This study emphasizes the significance of tumor budding, its relevance to prognosis, and reproducibility, as well as the significance of its evaluation and incorporation into routine surgical pathology practice in the management of OSCC. As a result, we believe that tumor budding is a crucial factor in determining tumor behavior.

SP3.8 Evaluation of remote surgical wound assessment in routine surgical practice: a mixed-methods pilot implementational study of a novel mobile digital intervention

Abstract Introduction Remote postoperative wound surveillance provides an opportunity to strengthen postoperative community care and minimise the burden of surgical-site infection (SSI). This study aimed to pilot remote digital postoperative wound surveillance and evaluate the readiness for implementation in routine practice. Methods A single-arm implementation study of remote postoperative wound surveillance in two tertiary care hospitals (clinicaltrials.gov: NCT05069103). Adults undergoing abdominal surgery received smartphone-delivered wound assessment for 30-days postoperatively (photographs and patient-reported SSI symptoms). Technology acceptance was assessed using 5-point Likert scales from the validated Telehealth Usability Questionnaire (TUQ) and summarised using means and 95% confidence intervals (CI). A mixed-methods approach was used with synthesis according to the WHO framework for monitoring and evaluating digital health interventions. Results 200 patients participated between July 2021 and April 2022, with 115 (57.5%) undergoing emergency procedures. The 30-day SSI rate was 16.5% (n=33/200), with 72.7% (n=24) diagnosed post-discharge. Usage of the intervention was 83.0% (n=166/200), with subsequently 74.1% (n=123/166) TUQ completion. Patient acceptance was high with regards to satisfaction (4.27, CI: 4.13-4.41) and usefulness (4.07, CI: 3.92-4.23). Communication was rated lowest (3.86, CI: 3.71-4.02), related to the desire for more frequent and personalised interactions with the surgical team. Nevertheless, the majority perceived improved quality (3.72, CI: 3.56-3.89) and efficiency (4.08, CI: 3.93-4.23) over routine postoperative care. Conclusion Remote postoperative wound surveillance successfully demonstrates readiness for implementation according to the WHO framework. Both patients and healthcare services can benefit from enhanced community support to ensure appropriate and timely management.

Debriefing to improve interprofessional teamwork in the operating room: A systematic review.

Debriefing has been pivotal in medical simulation training, but its application to the real-world operating room environment has been challenging. We reviewed the literature on routine surgical debriefing with special reference to its implementation, barriers, and effectiveness. Descriptive systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria were papers pertaining to debriefing in routine surgical practice. Excluded were papers reporting simulation training. We searched Google Scholar, CINAHL, Web of Science Core Collection, PsychINFO, Medline, Embase, and ProQuest Theses & Dissertations Global. The last search was performed on March 14, 2022. Quality was assessed on a 21-point checklist adapted from a standard reporting guideline. Synthesis was descriptive. The search process resulted in 19 papers. Publication dates ranged from 2007-2022. Study methods included surveys, interviews, and analysis of administrative data. Five papers involved a specific intervention. Quality scores ranged from 12-19 out of 21. On synthesis, we identified five topics: explanations of how debriefing had been implemented; the value of coaching and audit; the learning dimensions of debriefing, both team learning and quality improvement at the organizational level; the effect of debriefing on patient safety or the organization's culture; and barriers to debriefing. Successful implementation programs were characterized by strong commitment from management and support by frontline workers. Integration with administrative quality and safety processes, and information feedback to frontline workers are fundamental to successful debriefing programs. Debriefing can improve teamwork, learning, and psychological safety but is difficult to practice in the operating room environment. It is relevant to review the benefits and barriers to debriefing, and to learn from the experience of others, in order to run better debriefing models in our own hospitals.

The Norwegian degenerative spondylolisthesis and spinal stenosis (NORDSTEN) study: study overview, organization structure and study population

PurposeTo provide an overview of the The Norwegian Degenerative spondylolisthesis and spinal stenosis (NORDSTEN)-study and the organizational structure, and to evaluate the study population.MethodsThe NORDSTEN is a multicentre study with 10 year follow-up, conducted at 18 public hospitals. NORDSTEN includes three studies: (1) The randomized spinal stenosis trial comparing the impact of three different decompression techniques; (2) the randomized degenerative spondylolisthesis trial investigating whether decompression surgery alone is as good as decompression with instrumented fusion; (3) the observational cohort tracking the natural course of LSS in patients without planned surgical treatment. A range of clinical and radiological data are collected at defined time points. To administer, guide, monitor and assist the surgical units and the researchers involved, the NORDSTEN national project organization was established.Corresponding clinical data from the Norwegian Registry for Spine Surgery (NORspine) were used to assess if the randomized NORDSTEN-population at baseline was representative for LSS patients treated in routine surgical practice.ResultsA total of 988 LSS patients with or without spondylolistheses were included from 2014 to 2018. The clinical trials did not find any difference in the efficacy of the surgical methods evaluated. The NORDSTEN patients were similar to those being consecutively operated at the same hospitals and reported to the NORspine during the same time period.ConclusionThe NORDSTEN study provides opportunity to investigate clinical course of LSS with or without surgical interventions. The NORDSTEN-study population were similar to LSS patients treated in routine surgical practice, supporting the external validity of previously published results.Trial registrationClinicalTrials.gov; NCT02007083 10/12/2013, NCT02051374 31/01/2014 and NCT03562936 20/06/2018.

O171 Evaluation of remote surgical wound assessment in routine surgical practice: a mixed-methods pilot implementational study of a novel mobile digital intervention

Abstract Introduction Remote postoperative wound surveillance provides an opportunity to strengthen postoperative community care and minimise the burden of surgical-site infection (SSI). This study aimed to pilot remote digital postoperative wound surveillance and evaluate the readiness for implementation in routine practice. Methods A single-arm implementational study of remote postoperative wound surveillance in two tertiary care hospitals (clinicaltrials.gov: NCT05069103). Adults undergoing abdominal surgery received smartphone-delivered wound assessment for 30-days postoperatively (photographs and patient-reported SSI symptoms). Technology acceptance was assessed using 5-point Likert scales from the validated Telehealth Usability Questionnaire (TUQ), and summarised using means and 95% confidence intervals (CI). A mixed-methods approach was used with synthesis according to the WHO framework for monitoring and evaluating digital health interventions. Results 200 patients participated between July 2021 and April 2022, with 115 (57.5%) undergoing emergency procedures. The 30-day SSI rate was 16.5% (n=33/200), with 72.7% (n=24) diagnosed post-discharge. Usage of the intervention was 83.0% (n=166/200), with subsequently 74.1% (n=123/166) TUQ completion. Patient acceptance was high with regards to satisfaction (4.27, CI: 4.13-4.41) and usefulness (4.07, CI: 3.92-4.23). Communication was rated lowest (3.86, CI: 3.71-4.02), related to the desire for more frequent and personalised interactions with the surgical team. Nevertheless, the majority perceived improved quality (3.72, CI: 3.56-3.89) and efficiency (4.08, CI: 3.93-4.23) over routine postoperative care. Conclusion Remote postoperative wound surveillance successfully demonstrates readiness for implementation according to the WHO framework. Both patients and healthcare services can benefit from enhanced community support to ensure appropriate and timely management.

Evaluation of remote digital postoperative wound monitoring in routine surgical practice

Remote digital postoperative wound monitoring provides an opportunity to strengthen postoperative community care and minimise the burden of surgical-site infection (SSI). This study aimed to pilot a remote digital postoperative wound monitoring service and evaluate the readiness for implementation in routine clinical practice. This was a single-arm pilot implementational study of remote digital postoperative wound monitoring across two tertiary care hospitals in the UK (IDEAL stage 2b, clinicaltrials.gov: NCT05069103). Adults undergoing abdominal surgery were recruited and received a smartphone-delivered wound assessment tool for 30-days postoperatively. Patients received 30-day postoperative follow-up, including the Telehealth Usability Questionnaire (TUQ). A thematic mixed-methods approach was used, according to the WHO framework for monitoring and evaluating digital health interventions. 200 patients were enroled, of whom 115 (57.5%) underwent emergency surgical procedures. Overall, the 30-day SSI rate was 16.5% (n = 33/200), with 72.7% (n = 24) diagnosed post-discharge. Usage of the intervention was 83.0% (n = 166/200), with subsequently 74.1% (n = 123/166) TUQ completion. There were no issues reported with feasibility of the technology, with the reliability (3.87, 95% CI: 3.73–4.00) and quality of the interface rated highly (4.18, 95%: 4.06–4.30). Patient acceptance was similarly high with regards to ease of use (4.51, 95% CI: 4.41–4.62), satisfaction (4.27, 95% CI: 4.13–4.41), and usefulness (4.07, 95% CI: 3.92–4.23). Despite the desire for more frequent and personalised interactions, the majority viewed the intervention as providing meaningful benefit over routine postoperative care. Remote digital postoperative wound monitoring successfully demonstrated readiness for implementation with regards to the technology, usability, and healthcare process improvement.

Validation of the Spanish electronic version of the BREAST-Q questionnaire

BackgroundPatient-reported outcome measures (PROMs) have gained considerable interest in health care moving beyond traditional outcome measures of morbidity and mortality. In breast cancer surgery, women's’ perceptions of appearance, function and quality of life have become increasingly important. The BREAST-Q questionnaire is a validated PROM for use in cosmetic and reconstructive breast surgery in clinical practice. The objective of this study was to validate the Spanish electronic version of the BREAST-Q questionnaire, to verify the measurement equivalence of digital and paper versions and to identify the possible disadvantages and advantages of implementing this new tool. MethodsThe study population included 113 patients undergoing breast cancer survey at a single hospital in Barcelona (Spain) who were able to complete both the electronic and paper versions of the preoperative module of the BREAST-Q questionnaire. ResultsThe intraclass correlation coefficient (ICC) in the four domains of the questionnaire between the two versions of the questionnaire was >0.9, with a weighted kappa of >0.74 at item level. The reliability of the internal consistency was also excellent, with Cronbach's alpha coefficient of >0.70 in all domains. Age was a limiting factor for the delivery of the electronic version of BREAST-Q, with 69 years of age as the cut-off point to obtain reliable results. ConclusionsThe interchangeability of the electronic and paper versions of the BREAST-Q questionnaire facilitates implementation of this instrument in routine surgical oncological practice.

Evidence-based Surgical Competency Outcomes from the Clinical Readiness Program.

1) Evaluate the value and strength of a competency framework for identifying and measuring performance requirements for expeditionary surgeons; 2) Verify psychometric integrity of assessment instrumentation for measuring domain knowledge and skills; 3) Identify gaps in knowledge and skills capabilities using assessment strategies; 4) Examine shared variance between knowledge and skills outcomes, and the volume and diversity of routine surgical practice. Expeditionary military surgeons provide care for patients with injuries that extend beyond the care requirements of their routine surgical practice. The readiness of these surgeons to independently provide accurate care in expeditionary contexts is important for casualty care in military and civilian situations. Identifying and closing performance gap areas are essential for assuring readiness. We implemented evidence-based processes for identifying and measuring the essential performance competencies for expeditionary surgeons. All assessment instrumentation was rigorously examined for psychometric integrity. Performance outcomes were directly measured for expeditionary surgical knowledge and skills and gap areas were identified. Knowledge and skills assessment outcomes were compared, and also compared to the volume and diversity of routine surgical practice to determine shared variance. Outcomes confirmed the integrity of assessment instrumentation and identified significant performance gaps for knowledge and skills in the domain. Identification of domain competencies and performance benchmarks, combined with best-practices in assessment instrumentation, provided a rigorous and defensible framework for quantifying domain competencies. By identifying and implementing strategies for closing performance gap areas, we provide a positive process for assuring surgical competency and clinical readiness.

DIFFERENTIAL DIAGNOSIS OF RIGHT ILIAC FOSSA MASS AND THEIR MANAGEMENT

Background: Right iliac fossa mass is a common clinical entity encountered in routine surgical practice. The mass arises from different anatomical structures with varied aetiologies that require a high clinical suspicion in its management. The reason being that the mass may range from being benign to most aggressively malignant lesion which encompasses various specialities of surgery like genitourinary, vascular, gynaecological and colorectal surgery. This was a prospective observational study conducted betw Methods: een October 2021 and September 2022 in Silchar Medical College and Hospital, Silchar, Assam. 45 cases were studied after detailed history and physical examination, relevant investigations were done, and different surgical procedures done were noted and histopathological examination of resected specimens was done. In this series Results: out of 45 patients studied, 35 patients (77.5%) were diagnosed to have appendicular mass, 05 cases (11%) appendicular abscess, 02 cases (4.5%) ileocaecal TB, 02 cases (4.5%) psoas abscess, 01 cases (2.5%) Ca Caecum. Most commonly encountered in 3rd decade followed by 4th decade of life with male predominance. RIF mass is a challenging clinical sce Conclusions: nario for the surgeons. Keeping in mind the various differential diagnosis with good clinical acumen supported by appropriate investigations, patients with RIF mass can be managed appropriately either by conservative or surgical management.

Assessment of tissue healing after periodontal and peri-implant surgery

Relevance. In clinical practice, a dentist usually faces surgical wound healing peculiarities. We know that wound healing by primary intention is preferable, but the postoperative period does not always go this way. In practice, doctors observe a variety of wound healing options, which are not always documented correctly and in full. An incomplete and unprecise diagnosis may lead to c omplications, including iatrogenic ones.Material and methods. This study included patients undergoing surgical treatment in the Samara dental outpatient department. The study assessed the healing of periodontal and peri-implant tissues on the 4th-5th day after surgery. One hundred-and-thirty subjects, aged 27 to 65 y.o., participated in the study.Results. The study revealed the criteria for oral surgical wound healing, which included density and quality of the approximation of wound edges, oedema, exudate, hyperemia, fibrin coat amount, and purulent discharge. The study also recorded the subjective sensations of the patients. After analyzing the postoperative wound condition, we divided the patients into groups according to a similar clinical situation. We identified six types of wound healing processes around implants and teeth. Thus, we formed classes and subclasses of our "Classification of periodontal and peri-implant surgical wound healing assessment." This classification will optimize and simplify communication between specialists and speed up medical charting. The analysis helped to develop and implement a decisionmaking algorithm for postoperative surgical site treatment.Conclusion. The method of soft tissue condition classification and treatment after periodontal and peri-implant surgery is easily reproducible and available in routine outpatient surgical practice. The algorithm will allow for the successful treatment of surgical wounds based on the wound-healing process characteristics.

Split & Join: An Efficient Approach for Simulating Stapled Intestinal Anastomosis in Virtual Reality.

Colorectal cancer is a life-threatening disease. It is the second leading cause of cancer-related deaths in the United States. Stapled anastomosis is a rapid treatment for colorectal cancer and other intestinal diseases and has become an integral part of routine surgical practice. However, to the best of our knowledge, there is no existing work simulating intestinal anastomosis that often involves sophisticated soft tissue manipulations such as cutting and stitching. In this paper, for the first time, we propose a novel split and join approach to simulate a side-to-side stapled intestinal anastomosis in virtual reality. We mimic the intestine model using a new hybrid representation - a grid-linked particles model for physics simulation and a surface mesh for rendering. The proposed split and join operations handle the updates of both the grid-linked particles model and the surface mesh during the anastomosis procedure. The simulation results demonstrate the feasibility of the proposed approach in simulating intestine models and the side-to-side anastomosis operation.

How to achieve the critical view of safety for safe laparoscopic cholecystectomy: Technical aspects.

Laparoscopic cholecystectomy is associated with a higher incidence of biliary/vasculobiliary injuries than open cholecystectomy. Anatomical misperception is the most common underlying mechanism of such injuries. Although a number of strategies have been described to prevent these injuries, critical view of safety method of structural identification seems to be the most effective preventive measure. The critical view of safety can be achieved in the majority of cases during laparoscopic cholecystectomy. It is highly recommended by various guidelines. However, its poor understanding and low adoption rates among practicing surgeons have been global problems. Educational intervention and increasing awareness about the critical view of safety can increase its penetration in routine surgical practice. In this article, a technique of achieving critical view of safety during laparoscopic cholecystectomy is described with the aim to enhance its understanding among general surgery trainees and practicing general surgeons.

Will the PRESERFLO™ MicroShunt impact the future of trabeculectomy practice? A UK and Éire Glaucoma Society National Survey.

To explore the attitudes of UK glaucoma specialists regarding the current and future practice of trabeculectomy and the novel PRESERFLO™ MicroShunt (PF-MS) device, and intentions to adopt the PF-MS into routine glaucoma surgical practice. Online survey of UK and Éire Glaucoma Society members. 43 glaucoma consultants completed the survey. All surgeons performed trabeculectomies (median of 40 annually) and 51% undertook PF-MS procedures (median of 22.5 annually). The mean duration of surgery was reported as 48.9 (SD 13.3) and 31.2 (SD 9.9) min for trabeculectomy and PF-MS respectively (p < 0.0001). For surgeons not currently using the PF-MS, 65% planned to do so. Respondents judged completion of 35 trabeculectomies and 10 PF-MS were required to achieve basic competence. 91% of participants predicted their trabeculectomy volume would decrease and 73% expected PF-MS usage to increase. Respondents reported a median of six and four follow-ups within 3 months post surgery for trabeculectomy and PF-MS respectively (p < 0.0001). Respondents reported trabeculectomy required more post-operative interventions than the PF-MS and 81.8% judged the patient experience to be better with the PF-MS. The PF-MS was deemed suitable for early visual field loss by 72% of respondents, severe visual field loss by 35% and normal tension glaucoma by 21%. The PF-MS has seen rapid adoption in the UK. Respondents predict its usage will significantly increase whilst trabeculectomies will decrease. They report the PF-MS is quicker to learn and perform, and requires less post-operative follow-ups and interventions which may facilitate a more efficient service delivery for patients requiring glaucoma surgery.