Operative Video Research Articles

Radical Spinal Cordectomy for Conus Glioblastoma: Technical Case Instruction: 2-Dimensional Operative Video

Radical Spinal Cordectomy for Conus Glioblastoma: Technical Case Instruction: 2-Dimensional Operative Video

Commentary: Cervicothoracic Deformity in the Setting of Adhesive Arachnoiditis: An Operative Video Article

Commentary: Cervicothoracic Deformity in the Setting of Adhesive Arachnoiditis: An Operative Video Article

Are YouTube Videos Useful in Robot-Assisted Segmentectomy Education?

Segmentectomy operation became a preferable operation for small lesions due to the importance of saving lung parenchyma. Using robotic technology has too many advantages for segmentectomy operations. Websites such as YouTube have become educational tools for surgical trainees. The aim of our study is to analyze YouTube videos for accurate and up-to-date information about robotic segmentectomy operations. The videos on www.youtube.com, which were reached on July 11, 2024, by using the keywords 'Robot segmentectomy' and 'Robotic segmentectomy lung', were evaluated in this research. The videos were evaluated by using the Journal of the American Medical Association (JAMA) scoring system, critical view of safety (CVS), and LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS). Eighty-one videos were included. Almost half of the videos (n = 42) were affiliated with university hospitals. Preoperative imaging was seen in 49% of all videos; however, the rates were 32% and 20.9% for patients' demographics and preoperative assessment information, respectively. Only 29.6% of the videos presented the placement of trocars during the presentation. It has become possible to record high-quality videos easily with developing technology. However, our results showed that many of the videos don't include the parameters, especially related to education. Therefore, we believe that those videos are inadequate for trainees.

In Situ M2 Bypass for Treatment of Fusiform Middle Cerebral Artery Bifurcation Aneurysm: Technical Case Instruction and Operative Video.

Fusiform middle cerebral artery (MCA) bifurcation aneurysms can be challenging to treat with standard endovascular or microsurgical techniques. The in situ side-to-side bypass technique represents an elegant revascularization option for these aneurysms when trapping becomes necessary. A man in his 50s presented for evaluation of an incidentally found fusiform, 10 mm, right MCA bifurcation aneurysm with involvement of both the inferior and superior M2 trunks. Plan was initially made for a right pterional craniotomy for trapping of the aneurysm with exclusion of the inferior M2 trunk, preservation of the superior M2 trunk, with superficial temporal artery bypass to the inferior M2 trunk. Intraoperatively, after arachnoid dissection, it became clear that the distal superior and inferior M2 branches would lie in close approximation without tension, thus superficial temporal artery-M2 bypass was deferred, and instead in situ side-to-side M2 bypass was performed. Here in our operative video, we highlight the critical steps of in situ side-to-side M2 bypass technique. We present a technical case instruction and operative video highlighting the in situ side-to-side bypass technique for treatment of a large fusiform MCA bifurcation aneurysm.

Investigation of the effects of YouTube videos about orthognathic surgery on people using machine learning-based emotion analysis algorithm

Objectives: This study aims to analyze the comments about orthognathic surgery-themed YouTube videos through artificial intelligence and remarking the emotional effects of videos on people. Material and Methods: In this study, the keyword “orthognathic surgery” was searched on YouTube. In pursuit of recording sub-video comments, comments were analyzed with a machine learning-based emotion analysis algorithm. Results: One thousand one hundred and forty-five comments were analyzed in the study. 2 of 4 surgery videos contain real surgery images. Two videos are animated videos about the details of the surgery. Emotions described in comments are sorted as fear (43.7%), joy (21%), anger (14.6%), and sadness (11.6%). Where comments are reviewed in the aspect of sentiment, negative comments were dense (59.3%), respectively, followed by positive (18.3%), very negative (10.6%), and very positive (2.7 %). Regarding sentiment, differences in comments on real and animation surgery videos are statistically significant (P < 0.05). A significance level of very negative comments was higher in real surgery videos (P = 0.015). Conclusion: Different video formats, animation or real videos, may be used for informing, but we think that watching real surgical operation videos may increase people’s preoperative anxiety.

Effect of Informative Cesarean Delivery Operative Steps Video on Maternal Anxiety Level: A Randomized Controlled Trial

Background Cesarean section is the most common obstetric procedure performed. This can lead to maternal anxiety, which is a significant contributor to postpartum depression. This can adversely affect pregnant women both mentally and emotionally, negatively impacting their well-being and family bonding. The aim of this study was to evaluate the effect of the addition of an informative cesarean section operative steps video on the maternal anxiety score compared with standard pre-cesarean section care. Methods This randomized controlled trial was conducted at Thammasat University Hospital, Thailand, between April and September 2023. Pregnant women who underwent their first cesarean section were allocated to two groups: intervention and control groups. Participants in the intervention group were required to watch a 5-minute informative video that elaborately described the process from pre-operative steps until post-operative care on the day scheduled for cesarean delivery. All participants received the same routine pre-operative and post-operative care. The State-Trait Anxiety Inventory (STAI) was used to measure both populations on two occasions: the day of scheduled cesarean delivery and postpartum day 1. Results A total of 178 women were recruited. The demographic and obstetric characteristics were similar between the two groups. The pre-operative STAI scores of the intervention and control groups were 42.9 and 44.1 points, respectively, with no significant difference. However, the post-operative anxiety score showed a significant decline in the intervention group compared to that in the control group (p = 0.002). Moreover, most of the participants in the intervention group showed a low level of anxiety after the operation, while half of the control group remained at a moderate to high level score. Conclusions The provision of an informative educational video before cesarean delivery is a powerful tool that significantly reduces cesarean operative anxiety and improves health outcomes. Thai Clinical Trials Registry on the 28 March 2023 (TCTR20230328001).

Splenic flexure mobilization: does body topography matter?

Splenic flexure mobilization can be technically challenging, and its oncological benefits remain uncertain. This study aims to explore the relationship between patient and clinical characteristics and splenic flexure mobilization time as well as the implications of prolonged splenic flexure mobilization duration. This retrospective cohort study includes 105 patients who underwent laparoscopic distal colorectal cancer surgery between 2013 and 2018. The study analyzed patient characteristics, duration of surgical steps, and postoperative outcomes. Splenic flexure mobilization time was assessed using operation videos, and the impact of patient-related factors on splenic flexure mobilization complexity was examined. The study identified significant correlations of higher body mass index (BMI) (p = 0.0086), weight (p = 0.002), and height (p = 0.043) with longer splenic flexure mobilization time. Gender did not significantly influence splenic flexure mobilization duration. Splenic flexure mobilization time was correlated with the durations of other individual surgical steps (Step 1: medial-to-lateral dissection [p = 0.0013], Step 2: pelvic dissection [p = 0.067], Step 3: dissection of white line and mobilization of descending colon [p = 0.0088], Step 5: stapling, resection, extraction of the specimen, and anastomosis [p = 0.04]) and the overall operation time (p < 0.0001). A 10-min cutoff point predicts the total operation time more efficiently than other potential thresholds. This research suggests that patient characteristics including BMI, weight, and height may serve as indicators for prolonged splenic flexure mobilization time in laparoscopic distal colorectal cancer surgery. Longer splenic flexure mobilization durations were correlated with extended durations of other surgical steps. A BMI-based approach to anticipate SFM duration may enhance preoperative planning, potentially aiding in surgical decision-making. E-10840098-772.02-61604 2.2.2019.

Minimally Invasive Cervical Synovial Cyst Resection: 2-Dimensional Operative Video.

Minimally Invasive Cervical Synovial Cyst Resection: 2-Dimensional Operative Video.

Assessing the Reliability of YouTube Content for Plastic Surgery Patient Information in Africa With the Modified DISCERN and JAMA Scores.

YouTube has become a popular source of health information, including plastic surgery. Given the platform's wide reach and potential influence on patient decisions, this study aimed to assess the quality of information available on YouTube for African audiences seeking plastic surgery procedures. This cross-sectional study extracted data from YouTube videos on plastic surgery relevant to Africa. A search strategy identified videos in English using keywords. The first 50 results for each term were included, with duplicates removed. Next, the metadata of videos published from inception to June 9, 2024, were extracted. Two reviewers independently assessed videos using standardized tools to evaluate reliability (modified DISCERN and JAMA criteria) and engagement (likes-to-views ratio [LVR] and comments-to-views ratio [CVR]). The Mann-Whitney U test was used for unadjusted bivariable comparisons. Then ordinal logistic and beta regression analyses were used to evaluate the primary (modified DISCERN and JAMA scores) and secondary (LVR and CVR) outcomes, with a statistical significance level set at 0.05. Eight hundred ninety-seven plastic surgery videos were analyzed, and 3.9% were published by African entities. Large subscriber count (coefficient = -6.9e-8, 95% confidence interval [CI] [-1.13e-7, -2.9e-8], P = 0.001), African-authored (coefficient = -0.85, 95% CI [-1.44, -0.25], P = 0.005), and advertising (coefficient = -1.01, 95% CI [-1.63, -0.57], P < 0.001) videos had lower modified DISCERN scores. Advertising videos equally had lower JAMA scores (coefficient = -1.29, 95% CI [-1.83, -0.74], P < 0.001). Academic videos had lower LVR (coefficient = -0.48, 95% CI [-0.66, -0.30], P < 0.001), whereas independent videos had higher LVR (coefficient = 0.40, 95% CI [0.26, 0.54], P < 0.001). Academic videos had lower CVR (coefficient = -0.40, 95% CI [-0.67, -0.13], P = 0.003), whereas videos with other purposes had higher CVR (coefficient = 0.37, 95% CI [0.10, 0.64], P = 0.007). This study underscores a potential disparity in the quality of online plastic surgery information based on video sources and purposes.

Commentary: Fully Endoscopic Microvascular Decompression of the Trochlear Nerve for Treatment of Medically Refractory Superior Oblique Myokymia: Technical Case Instruction and Operative Video.

Commentary: Fully Endoscopic Microvascular Decompression of the Trochlear Nerve for Treatment of Medically Refractory Superior Oblique Myokymia: Technical Case Instruction and Operative Video.

Fully Endoscopic Microvascular Decompression of the Trochlear Nerve for Treatment of Medically Refractory Superior Oblique Myokymia: Technical Case Instruction and Operative Video.

We describe, to our knowledge, the first report of fully endoscopic microvascular decompression (MVD) of the trochlear nerve in a patient with superior oblique myokymia (SOM). A 51-year-old female presented with multiple years of intermittent, "jumpy," and "shimmering" visual disturbances. She was diagnosed with SOM. Magnetic resonance imaging showed right trochlear nerve compression within the perimesencephalic cistern between the free edge of the right tentorial leaflet and the right superior cerebellar artery. She underwent fully endoscopic MVD of the trochlear nerve with complete resolution of symptoms. Endoscopic MVD of the trochlear nerve is technically feasible and may be used to treat medically refractory SOM.

Identifying Responsible Factors for Poor Surgical Visibility in Pediatric Laparoscopic Fundoplication: A Retrospective Single-Center Study.

Background: Laparoscopic fundoplication is commonly performed in patients with neurological impairment. However, these patients often have spinal deformities that can complicate achieving a clear surgical view. This study aimed to identify factors associated with poor visibility in pediatric laparoscopic fundoplication. Methods: Operative videos, medical records, and radiographs of patients who underwent laparoscopic fundoplication between 2015 and 2023 were retrospectively reviewed. The videos were reviewed by two pediatric surgeons and classified into good or poor visibility groups. Age, sex, height, weight, history of abdominal surgery, lordosis, operative time, blood loss, and intraoperative complications were compared between the two groups. Lordosis was evaluated using the sagittal view of computed tomography images, and the anterior vertebral depth and abdominal thickness were measured to calculate the ratio. Results: Forty-one patients were included in this study. Based on the video review, the patients were classified into good (20 patients) and poor (21 patients) visibility groups. The median age, height, and weight were 6 years, 110 cm, and 16.1 kg, respectively. In the poor visibility group, 23.8% of patients had a history of abdominal surgery (P = .048). Additionally, the anterior vertebral depth to abdominal thickness ratios at the first and third lumbar vertebrae were significantly lower in the poor visibility group (P = .016 and P = .0018, respectively). There were no significant differences in the operative time, blood loss, or intraoperative complications between the two groups. Conclusions: Lordosis and a history of abdominal surgery may be risk factors for poor visibility in pediatric laparoscopic fundoplication.

2-Dimensional Operative Video for Staged Treatment of a Giant Plasma Cell Tumor: Principles for Neurosurgical Oncology During a Wartime Environment in Ukraine.

2-Dimensional Operative Video for Staged Treatment of a Giant Plasma Cell Tumor: Principles for Neurosurgical Oncology During a Wartime Environment in Ukraine.

Anatomical recognition artificial intelligence for identifying the recurrent laryngeal nerve during endoscopic thyroid surgery: A single-center feasibility study.

We investigate the feasibility of using artificial intelligence (AI) to identify the recurrent laryngeal nerve (RLN) during endoscopic thyroid surgery and evaluated its accuracy. In this retrospective study, we develop an AI model using a dataset of endoscopic thyroid surgery videos, including hemithyroidectomy procedures performed between April 2019 and September 2023 at the National Cancer Center Hospital East, Chiba, Japan. Semantic segmentation deep learning methods were applied to analyze the endoscopic thyroid surgery videos. Forty endoscopic thyroid surgery videos, all in high definition or better quality, were analyzed. The Dice values were 0.351, 0.568, and 0.746 for the inferior thyroid artery, RLN, and trachea, respectively. Data augmentation was performed by cropping, standardizing, and resizing to reduce false positives and improve accuracy. The AI model showed high recognition accuracy of the RLN and trachea. This method holds potential for assisting in future cervical gasless endoscopic surgeries.

SeeSaw: Learning Soft Tissue Deformation from Laparoscopy Videos with GNNs.

A major challenge in image-guided laparoscopic surgery is that structures of interest often deform and go, even if only momentarily, out of view. Methods which rely on having an up-to-date impression of those structures, such as registration or localisation, are undermined in these circumstances. This is particularly true for soft-tissue structures that continually change shape - in registration, they must often be re-mapped. Furthermore, methods which require 'revisiting' of previously seen areas cannot in principle function reliably in dynamic contexts, drastically weakening their uptake in the operating room. We present a novel approach for learning to estimate the deformed states of previously seen soft tissue surfaces from currently observable regions, using a combined approach that includes a Graph Neural Network (GNN). The training data is based on stereo laparoscopic surgery videos, generated semi-automatically with minimal labelling effort. Trackable segments are first identified using a feature detection algorithm, from which surface meshes are produced using depth estimation and delaunay triangulation. We show the method can predict the displacements of previously visible soft tissue structures connected to currently visible regions with observed displacements, both on our own data and porcine data. Our innovative approach learns to compensate non-rigidity in abdominal endoscopic scenes directly from stereo laparoscopic videos through targeting a new problem formulation, and stands to benefit a variety of target applications in dynamic environments. Project page for this work: https://gitlab.com/nct_tso_public/seesaw-soft-tissue-deformation.

Video-Instrument Synergistic Network for Referring Video Instrument Segmentation in Robotic Surgery.

Surgical instrument segmentation is fundamentally important for facilitating cognitive intelligence in robot-assisted surgery. Although existing methods have achieved accurate instrument segmentation results, they simultaneously generate segmentation masks of all instruments, which lack the capability to specify a target object and allow an interactive experience. This paper focuses on a novel and essential task in robotic surgery, i.e., Referring Surgical Video Instrument Segmentation (RSVIS), which aims to automatically identify and segment the target surgical instruments from each video frame, referred by a given language expression. This interactive feature offers enhanced user engagement and customized experiences, greatly benefiting the development of the next generation of surgical education systems. To achieve this, this paper constructs two surgery video datasets to promote the RSVIS research. Then, we devise a novel Video-Instrument Synergistic Network (VIS-Net) to learn both video-level and instrument-level knowledge to boost performance, while previous work only utilized video-level information. Meanwhile, we design a Graph-based Relation-aware Module (GRM) to model the correlation between multi-modal information (i.e., textual description and video frame) to facilitate the extraction of instrument-level information. Extensive experimental results on two RSVIS datasets exhibit that the VIS-Net can significantly outperform existing state-of-the-art referring segmentation methods. We will release our code and dataset for future research (Git).

Microsurgical Resection of Giant Left Clinoid Meningioma: The Meticulous Dissection of Encased Blood Vessels and Bleeding Control Using the Yasargil “Welding” Technique: A 2-Dimensional Operative Video

Microsurgical Resection of Giant Left Clinoid Meningioma: The Meticulous Dissection of Encased Blood Vessels and Bleeding Control Using the Yasargil “Welding” Technique: A 2-Dimensional Operative Video

Indocyanine Green Angiography–Assisted Marsupialization of a Petrous Apex Cholesterol Granuloma: 2-Dimensional Operative Video

Indocyanine Green Angiography–Assisted Marsupialization of a Petrous Apex Cholesterol Granuloma: 2-Dimensional Operative Video

Use of the Median Sulcus Entry Zone for Microsurgical Resection of a Ruptured Cavernous Malformation of the Pons: A 2-Dimensional Operative Video

Use of the Median Sulcus Entry Zone for Microsurgical Resection of a Ruptured Cavernous Malformation of the Pons: A 2-Dimensional Operative Video

Endoscopic Transsphenoidal Resection of a Retroinfundibular Craniopharyngioma With Preservation of the Pituitary Stalk: 2-Dimensional Operative Video

Endoscopic Transsphenoidal Resection of a Retroinfundibular Craniopharyngioma With Preservation of the Pituitary Stalk: 2-Dimensional Operative Video