Traditional Surgical Methods Research Articles

RECENT DEVELOPMENTS IN ENDOVASCULAR THERAPY FOR CHRONIC SUBDURAL HEMATOMAS USING LIQUID EMBOLIC AGENTS

Chronic subdural hematomas (cSDH) remain a significant challenge in neurosurgery, particularly among the elderly. Recent advancements in endovascular therapy, specifically the use of non-adhesive embolic agents, have shown promise in improving outcomes for these patients. This presentation will delve into the latest developments and clinical evidence surrounding this innovative approach. The discussion will include findings from recent randomized trials that have evaluated the efficacy and safety of embolisation with non-adhesive agents, both as a standalone treatment and in conjunction with traditional surgical methods. Technical outcomes from these studies will be analyzed, highlighting key differences in patient recovery, complication rates, and long-term results between the combined and isolated approaches. One of the focal points of the presentation will be the technical nuances of performing embolisation, emphasizing the procedural intricacies and the choice of embolic materials. Comparative data will be presented to illustrate the benefits of non-adhesive agents over other embolisation methods, particularly in terms of reducing re-bleeding rates and minimizing invasive interventions. Additionally, we will explore future implications of widespread adoption of this technique, including its potential to alter standard care practices and improve patient prognoses. Projections will be made regarding the impact on healthcare resources, patient quality of life, and overall survival rates. The presentation aims to provide a comprehensive overview of the current state and future potential of endovascular therapy for cSDH, offering valuable insights for neurosurgeons and interventional radiologists seeking to enhance their therapeutic arsenal.

Giant renal artery aneurysm with severe compression of the right kidney.

Renal artery aneurysm (RAA) is a rare condition among visceral aneurysms, often asymptomatic and incidentally discovered through imaging. Surgical or interventional procedures are utilized for treatment, depending on the aneurysm's size, morphology, and the patient's physical condition, to prevent rupture. A patient was admitted with a giant asymptomatic RAA, measuring a maximum diameter of 11cm on a serendipitous occasion. We successfully accomplished a full embolization treatment for the aneurysm, exclusively utilizing inflow tract embolization techniques. Six months post-treatment, a follow-up abdominal ultrasound examination demonstrated a notable decrease in the aneurysm's diameter, signifying the positive outcome of our intervention. This approach offers a feasible alternative in challenging cases, especially when traditional surgical methods are not feasible or carry significant risks.

Percutaneous Sclerotherapy of Cystic Lesions at Kenyatta National Hospital: Indications, Outcomes, Efficacy, and Complications

Background: Percutaneous sclerotherapy is a minimally invasive treatment for cystic lesions and has emerged as a preferred alternative to traditional surgical methods due to its faster recovery times and lower complication rates. A sclerosing agent is instilled into the lesion causing cyst wall inflammation and lesion shrinkage. It has a significant role in managing cystic lesions, with better health outcomes. Objectives: To evaluate the indications, outcomes, efficacy, and complications of percutaneous sclerotherapy in the management of cystic lesions. Methodology: The study was a prospective cross-sectional study involving patients with cystic lesions referred for percutaneous sclerotherapy. Data was collected, analyzed, and presented in percentages, graphs, tables. Technical and clinical success rates were calculated. Efficacy was analyzed using chi-square test. Results: 27 patients with cystic lesions were treated. Most were females (77.8%), and males (22.2%), with a male-to-female ratio of 1:3.5. The commonest indication was pain (26.1%), followed by pressure symptoms (22.7%) and abnormal swelling (20.5%). Most lesions were located in the liver (25.9%), followed by the kidney (18.5%). Majority had significant improvement in clinical symptoms and size reduction with p-values < 0.05. The technical success rate was 100% and the clinical success rate was 96.3%. Minor complications were encountered including mild pain (7.4%), catheter blockage, cyst abscess formation, catheter insertion site infection, and inflammatory cyst septations (each 3.7%). Conclusion: Percutaneous sclerotherapy is a safe, efficacious treatment of cystic lesions with a high technical and clinical success rate. It should be considered as a first line of treatment for cystic lesions.

Evaluating robotic assistance on the learning curve and efficiency of mandibular angle ostectomy: an animal model study.

This study evaluated the efficacy and learning curve of a maxillofacial surgical robotic system (MSRS) guided by electromagnetic navigation for mandibular angle ostectomy (MAO), compared to traditional surgical methods. The study utilized a controlled experiment involving thirty rabbits, paired divided into experimental and control groups. The experimental group underwent MAO using the MSRS, while the control group was treated with conventional surgical techniques. The surgeons performing the procedures were inexperienced in robotic surgery and MAO to assess the learning curve and the impact of robotic assistance. Key parameters measured included the accuracy of ostectomy, setup time, and ostectomy efficiency, with data analyzed through a paired-t test to compare the performance between the two groups. The study indicated a significant reduction in ostectomy time for the experimental group, with improved accuracy and efficiency in ostectomy. The study found that robotic assistance could decrease the risk of complications and enhance surgical outcomes. It also highlighted the presence of an initial learning curve when adopting new robotic technologies, which could be mitigated through adequate training and simulation practices. Using MSRS for MAO could lead to faster early learning curves and increased ostectomy efficiency compared to traditional surgical methods. It demonstrated the potential benefits of integrating robotic systems into craniofacial surgery, suggesting a promising direction for future surgical practices.

Evaluation of the utility of surgical simulation software in medical postgraduate education

BackgroundThe use of medical simulation software in medical institutions is growing to address teaching challenges. The study aims to assess the effectiveness of the Touch Surgery app, a free medical simulation software, as a supplement to the teaching methodology of unified surgery for medical students. MethodsTwenty-three postgraduate students, divided into three groups based on residency training years, and five senior orthopedic surgeons took part in the study. Each participant completed three modules within the Large External Fixators module using the Touch Surgery app. The results achieved by orthopedic specialists and postgraduates in the test module were recorded separately. The orthopedic specialists' first test module scores were used as a baseline. A Likert survey assessed the usefulness and content accuracy of the app. Statistical analysis included analysis of variance and 2-tailed t-test. ResultsThe first and second scores achieved by the postgraduates in the three groups were significantly different from the baseline of the orthopedic specialists, but the mean scores of all postgraduate's groups increased with simulator usage for learning and by the third attempt they were at the same level as the orthopedic specialists. However, no significant performance differences were observed between postgraduates with different training years. Postgraduates expressed a positive opinion of the usefulness and content of Touch Surgery in the questionnaire and their intention to continue using it in their future studies. ConclusionsThis study shows that the use of Touch Surgery improves postgraduates' performance and ultimately enables them to reach the level of orthopedic specialists in simulated surgery, and received positive ratings for the software's experience and content. Touch Surgery can be a valuable complement to traditional surgical teaching methods, bridging the gap between theoretical learning from textbooks and guided rehearsals of surgical steps and skills.

Study on the efficacy of 3D printing technology combined with customized plates for the treatment of complex tibial plateau fractures

BackgroundAnatomical reduction and stable fixation of complex tibial plateau fractures remain challenging in clinical practice. This study examines the efficacy of using 3D printing technology combined with customized plates for treating these fractures.MethodsWe retrospectively analyzed 22 patients treated with 3D printing and customized plates at the Orthopedic Department of the Central Hospital affiliated with Shenyang Medical College from September 2020 to January 2023. These patients were matched with 22 patients treated with traditional plates with similar baseline characteristics. Patients were divided into an experimental group (3D-printed models and customized plates) and a control group (traditional plates). The control group underwent traditional surgical methods, while the experimental group had a preoperative 3D model and customized plates for surgical planning. We compared baseline characteristics and recorded various indicators, including preoperative preparation time, surgical time, intraoperative blood loss, number of intraoperative fluoroscopies, hospital stay duration, fracture healing time, complications, knee joint range of motion (ROM), Rasmussen anatomical and functional scores, and HSS scores.ResultsAll surgeries were successful with effective follow-up. The experimental group had shorter surgical time, less intraoperative blood loss, and fewer intraoperative fluoroscopies (P < 0.05). At 6 months and 1 year postoperatively, the experimental group had better knee joint HSS scores than the control group. Preoperative preparation time and total hospital stay were shorter in the control group (P < 0.05). There were no significant differences in fracture healing time and follow-up duration between groups. The experimental group showed better knee joint flexion angles (P < 0.05). Rasmussen scores showed no statistical difference between groups (P > 0.05). The incidence of complications was slightly lower in the experimental group but not significantly different.Conclusion3D printing technology combined with customized plates for complex tibial plateau fractures enables precise articular surface reduction, significantly shortens surgical time, and reduces intraoperative blood loss. This method improves knee joint function, offering a more effective treatment option.

The development, implementation principles and application of the endoscopic super minimally invasive surgery

Endoscopic therapy has gone through three stages of development: intraluminal treatment, endoscopic tunneling technology, and endoscopic super minimally invasive surgery (ESMIS). Compared to the drawbacks of traditional surgical methods"organ resection and anatomical reconstruction", super minimally invasive surgery (SMIS) emphasizes the surgical concept of"curing diseases while preserving organs and functions". SMIS conducts treatment through four channels: natural cavity channel, tunnel channel, puncture channel, and multi cavity channel. It offers dozens of surgical methods for diagnosing and treating gastrointestinal diseases. At present, relatively sound implementation principles for ESMIS treatment have been established to ensure the safety and effectiveness of surgery, and to continuously expand other diagnostic and therapeutic fields.

FP6.6 - Diagnosing the improvements required for enhancing the medical student ward round bedside teaching experience utilising a cohort of surgical teaching fellows

Abstract Aim After previously having mixed student feedback as a learning experience, our UK medical school have embedded a cohort of dedicated surgical teaching fellows into acute surgical ward rounds. Since this has happened, we aimed to further improve traditional Surgical Ward Round Bedside Teaching methods. Method Post event, retrospective, optional questionnaire formed of 5 Questions evaluated by a Likert scale and 2 open ended Questions. Presented to year 3, UK undergraduate medical students. Results 20 complete responses received. The majority of students strongly agreed that Surgical Ward Round Bedside Teaching sessions with dedicated fellows present were effective in enhancing clinical knowledge and skills. 90% strongly agreed that teaching fellows were engaging and approachable during Surgical Ward Round Bedside Teaching. Also 90% strongly agreed that they felt comfortable asking questions and seeking clarification during Surgical Ward Round Bedside Teaching sessions. However, only 60% strongly agreed that Surgical Ward Round Bedside Teaching sessions were well-organized and focused on relevant surgical/clinical cases. When asked ‘How could the bedside/Ward Round teaching sessions be improved?’ – Responses revolved around suggesting teaching in smaller groups, reminding wards/departments to expect students/clinical fellows, providing online resources or hand-outs before teaching, identifying teaching session objectives, and spend more time on history taking and examination sessions Conclusions The introduction of surgical teaching fellows has had a positive impact on the student Surgical Ward Round Bedside Teaching experience. There is still room for future refinement however and further enhancement strategies are in progress.

Advancements of the 21st century and Their Implications on Medical Research and Diagnosis

Throughout the 20th century, new research and new demands have led to an increased amount of technology used in medicine. These methods have led to early detection, better context of conditions, increased efficiency, and brighter prospects for the future of medical diagnosis. However, the increasing use of AI and genetics in medicine has called for checks and further clinical trials to determine how ethical these practices might be. The debate surrounding the integration of Artificial Intelligence has created further controversy—that is, what technologies should be used and what technologies should not be used. To determine a solution, certain factors should be considered including the comfort of patients during treatments including advanced technology, the risk factor of integrating AI into procedures, and the efficiency of technology compared to traditional medical practices. For example, imaging technologies such as X-ray and sonography are found to be more comfortable for patients due to their long-standing familiarity, yet their precision and accuracy fall short in comparison to advanced Imaging technologies such as CT, MRI, and PET scans. There has also been discussion of the use of genetic testing such as chromosomal microarrays. Advances in genetic testing have led to the ability to detect conditions in embryos which can be beneficial, but the manipulation of the embryos could raise ethical concerns. Past ethical grey areas, there have been amazing prospects for the future of medicine and these innovations, such as the use of non-invasive testing which is an emerging alternative to traditional surgical methods. Through extensive literary research, this paper considers the multiple aspects that should contribute to deciding to implement technological advancements brought in the 21st Century. By investigating previous integrations of innovations within medicine, this research could envision a risk-free and more ethical approach to advancing medicine with technology.

Advancements in Surgical Approaches for Sacrococcygeal Pilonidal Sinus: A Comprehensive Review.

Sacrococcygeal pilonidal sinus (SPS) is a condition involving the formation of a cavity in the lower back region. It is more common among young adults and is influenced by factors such as sitting for long periods, body hair, and certain lifestyle habits. Surgical treatment is often necessary for recurring or severe cases, and various surgical techniques available, ranging from traditional surgical methods to newer, less invasive approaches. This comprehensive review examines the progress in surgical techniques for managing SPS, emphasizing the effectiveness, safety, and patient outcomes associated with different methods. It provides an overview of traditional procedures, such as excision with primary closure, and contrasts these with recent innovations like endoscopic and laser-assisted techniques. The review also considers advanced technologies, including the potential of robotic surgery and the use of specialized materials. By assessing clinical outcomes, recurrence rates, complications, and patient satisfaction, this review seeks to identify the most effective surgical strategies for SPS. Additionally, it discusses recent technological advancements and highlights areas needing further research to improve the management and treatment of this condition.

Improved Thoracoscopic-Assisted Surgery for the Treatment of Metastatic Thoracic Vertebral Tumors.

The significant progress made in the diagnosis and treatment of malignant tumors has led to improved patient survival rates. However, the metastatic spread of these tumors to the thoracic vertebrae remains a significant challenge, often resulting in bone-related adverse events, such as pathological fractures and severe complications. To address this issue, a refined multidisciplinary approach has been explored, which utilizes thoracoscopic techniques for tumor resection and spinal interventions. Thoracoscopic techniques offer a minimally invasive alternative to traditional open surgical methods, aiming to reduce the overall trauma experienced by patients. By leveraging the advantages of thoracoscopy, clinicians can effectively resect metastatic tumors within the thoracic vertebrae while minimizing the impact on surrounding tissues and structures. This approach, combined with targeted spinal interventions, has the potential to improve patient outcomes and quality of life by mitigating the debilitating effects of pathological fractures and other complications associated with metastatic bone disease. The implementation of this multidisciplinary strategy, incorporating thoracoscopic tumor resection and spinal interventions, represents a promising avenue for the management of metastatic tumors within the thoracic vertebrae. Further research and clinical evaluation are necessary to fully elucidate the long-term benefits and establish the optimal treatment protocols for this patient population, ultimately enhancing the care and outcomes for individuals afflicted by this challenging condition.

A Comparative Analysis of the Advances in Scar Reduction: Techniques, Technologies, and Efficacy in Plastic Surgery.

The study provides a comprehensive analysis of the latest methodologies and treatments aimed at improving scar management. Scar formation results from the replacement of normal skin with fibroblasts, leading to a structured unidirectional collagen bundle, as opposed to the collagen sheet matrix found in healthy skin. This review categorizes scars into hypertrophic scars and keloids, each with distinct pathophysiological characteristics. It highlights the importance of consistent scar assessment using scales such as the Vancouver Scar Scale and the Patient and Observer Scar Assessment Scale, emphasizing the need for standardized evaluation methods. The study systematically reviews various scar management techniques, ranging from traditional surgical methods to innovative treatments. Conventional approaches such as pressure garments and silicone gel sheeting are explored, noting their roles in maintaining hydration and occlusion. The efficacy of intralesional corticosteroid injections and laser therapies is discussed, with particular attention given to their combined use for optimal outcomes. The review also covers advanced techniques such as microneedling, platelet-rich plasma therapy, and stem cell-based treatments, detailing their mechanisms and potential benefits in scar remodelling. Additionally, the study underscores the emerging role of botulinum toxin A in both preventive and corrective scar treatments, offering promising results in reducing movement-induced scar exaggeration. The systematic review includes a thorough examination of existing literature, clinical trials, and meta-analyses to evaluate the effectiveness of these interventions. It concludes by calling for further research to refine these techniques and enhance their application in clinical practice, aiming to achieve better aesthetic and functional outcomes for patients with scars.

Application of smart hydrogel materials in cartilage injury repair: A systematic review and meta-analysis.

Cartilage injury is a common clinical condition, and treatment approaches have evolved over time from traditional conservative and surgical methods to regenerative repair. In this context, hydrogels, as widely used biomaterials in the field of cartilage repair, have garnered significant attention. Particularly, responsive hydrogels (also known as "smart hydrogels") have shown immense potential due to their ability to respond to various physicochemical properties and environmental changes. This paper aims to review the latest research developments of hydrogels in cartilage repair, utilizing a more systematic and comprehensive meta-analysis approach to evaluate the research status and application value of responsive hydrogels. The goal is to determine whether these materials demonstrate favorable therapeutic effects for subsequent clinical applications, thereby offering improved treatment methods for patients with cartilage injuries. This study employed a systematic literature search method to summarize the research progress of responsive hydrogels by retrieving literature on the subject and review studies. The search terms included "hydrogel" and "cartilage," covering data from database inception up to October 2023. The quality of the literature was independently evaluated using Review Manager v5.4 software. Quantifiable data was statistically analyzed using the R language. A total of 7 articles were retrieved for further meta-analysis. In the quality assessment, the studies demonstrated reliability and accuracy. The results of the meta-analysis indicated that responsive hydrogels exhibit unique advantages and effective therapeutic outcomes in the field of cartilage repair. Subgroup analysis revealed potential influences of factors such as different types of hydrogels and animal models on treatment effects. Responsive hydrogels show significant therapeutic effects and substantial application potential in the field of cartilage repair. This study provides strong scientific evidence for their further clinical applications and research, with the hope of promoting advancements in the treatment of cartilage injuries.

A 5-year Evaluation of the Recurrence Rate Following Conventional Surgery and Ablation for Venous Insufficiency Revealed That Although Ablation Methods Were Employed, Conventional Surgery Was Not Abandoned

Objectives: Although conventional surgery (CS) has been less frequently employed in the treatment of great saphenous vein (GSV) in recent years, our clinic has not entirely abandoned this method. The objective of this study was to evaluate the recurrence and symptoms of patients treated with CS and radiofrequency ablation (RFA) for venous insufficiency (VI) 5 years ago. Methods: A retrospective review was conducted on the results of 233 patients who were treated for varicose veins in our clinic 5 years ago (all in the same year). Patients aged 20 years or older with clinical class C2 to C6 clinical, etiological, anatomical, pathophysiological and GSV diameter &gt;5.5 mm, reflux degree of at least 0.5 s were treated with RFA or conventional stripping. A total of 121 patients were treated with CS and 112 patients were treated with RFA. The method to be applied to the patients was randomly assigned without prior planning. The quality of life and recurrence rate were evaluated using the venous clinical severity score before surgery and at 1-month and 5-year intervals following surgery. Results: In 2017, 233 patients were treated with RFA and CS methods due to VI (n=112, n=121). Clinical follow-up and examinations were conducted at the 1st week, 1st month, and 5th year after surgery. A comparison of the two groups revealed that RFA was non-inferior to CS in terms of clinical relapse after 5 years. However, in terms of recurrence, the situation was 16.36% (n=9) in CS and 46.80% (n=22) in RFA. Recurrence was found to be significantly associated with the operational technique (p&lt;0.006). Furthermore, the recurrence rate was significantly higher among patients who underwent venous pouch excision simultaneously with the main procedure (90.84%, n=139) compared to those who did not (9.15%, n=14; p&lt;0.05). Conclusion: As long as the recurrence rate of the traditional surgical stripping method remains low in the treatment of VI, this method will continue to be valuable. Although ablation methods are effective in our clinic, we have not abandoned traditional surgery. Since traditional surgery greatly reduces the risk of reoperation after many years, it should be recommended as an alternative choice to patients who are indicated for the procedure.

Extended Reality-Based Head-Mounted Displays for Surgical Education: A Ten-Year Systematic Review.

Surgical education demands extensive knowledge and skill acquisition within limited time frames, often limited by reduced training opportunities and high-pressure environments. This review evaluates the effectiveness of extended reality-based head-mounted display (ExR-HMD) technology in surgical education, examining its impact on educational outcomes and exploring its strengths and limitations. Data from PubMed, Cochrane Library, Web of Science, ScienceDirect, Scopus, ACM Digital Library, IEEE Xplore, WorldCat, and Google Scholar (Year: 2014-2024) were synthesized. After screening, 32 studies comparing ExR-HMD and traditional surgical training methods for medical students or residents were identified. Quality and bias were assessed using the Medical Education Research Study Quality Instrument, Newcastle-Ottawa Scale-Education, and Cochrane Risk of Bias Tools. Results indicate that ExR-HMD offers benefits such as increased immersion, spatial awareness, and interaction and supports motor skill acquisition theory and constructivist educational theories. However, challenges such as system fidelity, operational inconvenience, and physical discomfort were noted. Nearly half the studies reported outcomes comparable or superior to traditional methods, emphasizing the importance of social interaction. Limitations include study heterogeneity and English-only publications. ExR-HMD shows promise but needs educational theory integration and social interaction. Future research should address technical and economic barriers to global accessibility.

Assessing the suitability of video-assisted anal fistula treatment for obese patients compared to conventional surgery: a question worth investigating

Background and aimsVideo-assisted anal fistula treatment (VAAFT) is an innovative surgical approach enabling the direct visualization of the fistula tract structure. This study aims to assess the efficacy of VAAFT in comparison with that of traditional surgical methods and explore potential risk factors contributing to fistula recurrence to provide new recommendations for surgical selection.Materials and methodsInformation was collected from 100 patients with complex anal fistula (CAF) in our hospital who underwent surgical treatment from January 2021 to January 2023. We compared the baseline information and surgical outcomes of two groups, analyzed the risk factors for fistula recurrence by using logistic regression analysis, and conducted further exploration by using the body mass index.ResultsEqual numbers of patients underwent VAAFT and traditional surgeries, and no significant differences in baseline information were observed. Patients who received VAAFT experienced less intraoperative bleeding (15.5 (14.0–20.0) vs. 32.0 (25.0–36.0)), shorter hospital stays (2.0 (2.0–2.5) vs. 3.0 (3.0–3.5)), reduced postoperative pain and wound discharge, but longer operative times (43.3 ± 6.9 vs. 35.0 (31.5–40.0)) compared with patients who underwent traditional surgeries. No significant differences in recurrence rates were found three and six months after operation (the p-values were 0.790 and 0.806, respectively). However, the Wexner scores of the VAAFT group were significantly low in the first follow-up (0 (0–1.0) vs. 2.0 (1.0–2.0)). Postoperative recurrence of fistulas may be associated with obesity (p-value = 0.040), especially in patients undergoing traditional surgeries (p-value = 0.036).ConclusionVAAFT offers advantages, such as less pain, less trauma, and faster recovery, compared with traditional surgical treatment. Obese patients with CAF are prone to recurrence, and we recommend that they undergo VAAFT treatment rather than traditional surgeries.

Impact of three-dimensional-printing technology guidance on surgical outcomes for retroperitoneal sarcoma: A propensity score-matched study.

The surgical treatment of retroperitoneal sarcoma (RPS) is highly challenging because of its complex anatomy. In this study, the authors compared the surgical outcomes of patients with RPS who underwent surgical resection guided by three-dimensional (3D) printing technology versus traditional imaging. This retrospective study included 251 patients who underwent RPS resection guided by 3D-printing technology or traditional imaging from January 2019 to December 2022. The main outcome measures were operative time, intraoperative blood loss, postoperative complications, and hospital stay. In total, 251 patients were enrolled in the study: 46 received 3D-printed navigation, and 205 underwent traditional surgical methods. Propensity score matching yielded 44 patients in the 3D group and 82 patients in the control group. The patients' demographics and tumor characteristics were comparable in the matched cohorts. The 3D group had significantly shorter operative time (median, 186.5 minutes [interquartile range (IQR), 130.0-251.3 minutes] vs. 210.0 minutes [IQR, 150.8-277.3 minutes]; p=.04), less intraoperative blood loss (median, 300.0 mL [IQR, 100.0-575.0 mL] vs. 375.0 mL [IQR, 200.0-925.0 mL]; p=.02), shorter postoperative hospital stays (median, 11.0 days [IQR, 9.0-13.0 days] vs. 14.0 days [IQR, 10.8-18.3 days]; p=.02), and lower incidence rate of overall postoperative complications than the control group (18.1% vs. 36.6%; p=.03). There were no differences with regard to the intraoperative blood transfusion rate, the R0/R1 resection rate, 30-day mortality, or overall survival. Patients in the 3D group had favorable surgical outcomes compared with those in the control group. These results suggest that 3D-printing technology might overcome challenges in RPS surgical treatment. The surgical treatment of retroperitoneal sarcoma (RPS) is highly challenging because of its complex anatomy. The purpose of this study was to investigate whether three-dimensional (3D) printing technology offers advantages over traditional two-dimensional imaging (such as computed tomography and magnetic resonance imaging) for guiding the surgical treatment of RPS. In a group of patients who had RPS, surgery guided by 3D-printing technology was associated with better surgical outcomes, including shorter operative time, decreased blood loss, shorter hospital stays, and fewer postoperative complications. These findings suggested that 3D-printing technology could help surgeons overcome challenges in the surgical treatment of RPS. 3D-printing technology has important prospects in the surgical treatment of RPS.

Advancements in Therapeutic Approaches for Proliferative Vitreoretinopathy: A Comprehensive Review.

Proliferative vitreoretinopathy (PVR) is a significant complication of retinal detachment surgery, characterized by the growth of fibrous membranes that can lead to recurrent retinal detachment and vision loss. This comprehensive review aims to summarize the latest advancements in the therapeutic approaches for PVR, encompassing historical perspectives, current surgical techniques, pharmacological interventions, biological and genetic therapies, and novel experimental treatments. Traditional surgical methods, such as vitrectomy, have been refined with advanced instrumentation and techniques to improve outcomes. Pharmacological treatments, including anti-inflammatory and anti-proliferative agents, are being explored to prevent and manage PVR. Emerging therapies, such as stem cell and gene therapy, offer promising new avenues for treatment. Despite these advancements, challenges remain in preventing recurrence and improving long-term outcomes. This review highlights the progress made and identifies areas for future research, emphasizing the importance of continued innovation to enhance patient care and reduce the burden of PVR.

Postoperative satisfaction and perception among laparoscopic cholecystectomy patients in Diyala Province, Iraq

Background: Over the past two decades, laparoscopic surgeries have significantly progressed, and surpassing traditional surgical methods across multiple medical fields. This study aims to assess the patients’ satisfaction and the related factors toward the laparoscopic cholecystectomy in Iraq. Methods: A cross-sectional study was conducted from April 2023 to 30th March 2024 at the Alkalis General Hospital and Al Hayat Private Hospital, Diyala province, Iraq. Semi-structured questionnaire was recruited to collect the pre and post operative data from patients. Statistical analysis was carried out using SPSS-21, with significance set at p &lt; 0.05. Results: Data of 157 patients with mean age (+ Standard Deviation) of 47.57 (SD +12.80) were analyzed. Most of them (53.5%) were females, operated in public hospitals (52.2%), unemployed (51.6%), and earned less than USD 400 (60.5%). The majority of patients expressed high overall satisfaction with the laparoscopic cholecystectomy procedure (42.7% being strongly satisfied and 38.9% satisfied). In the multiple logistic regression, the patients who were operated in private hospital (OR = 4.506, 95% CI: 1.394 to 14-577; P-value= 0.012), with monthly income exceeds USD 400 (OR = 4.887, 95% CI: 1.531 to 15.601; P-value=0.007), involved in the choosing of surgery technique (OR = 5.596, 95% CI: 1.425 to 21.982; P-value=0.014), and those recommend laparoscopic cholecystectomy for others (OR = 9.100, 95% CI: 1.425 to 21.982; P-value=0.001), had the highest odds ratios. The Hosmer and Lemeshow test indicated a good fit (p = 0.552). Conclusion: Patient satisfaction is high especially among high income patients operated in private hospital however, the perception of postoperative outcomes remains important areas of focus, particularly in regions with unique healthcare challenges like Iraq.

Complete transection of the bilateral main bronchus in a 5-year-old patient: a case report

BackgroundTracheobronchial injuries caused by blunt chest trauma are rare in children, and such injuries usually involve multiple organs. Most cases involve respiratory failure on the way to the hospital, and the mortality rate is high. Herein, we describe the case of a 5-year-old patient who fell from an electric vehicle, causing complete rupture of the bilateral main bronchus.Case presentationWe treated a 5-year-old patient with complete bilateral main bronchus rupture. Chest computed tomography (CT) failed to detect bronchial rupture. Continuous closed thoracic drainage resulted in a large amount of bubble overflow. Tracheal rupture was suspected. Fibreoptic bronchoscopy revealed complete rupture of the right main bronchus and rupture of the left main bronchus. Emergency tracheoplasty was performed under cardiopulmonary bypass (CPB). During the operation, we found that the bilateral main bronchi were completely ruptured. Postoperative recovery was smooth. The traditional surgical method for treating these injuries is lateral thoracotomy. However, a median sternotomy provides a better opportunity for selective repair. Extracorporeal circulation-assisted surgery is required for patients with unstable breathing.ConclusionComplete fractures of the bilateral main bronchi are rare. Bronchial rupture should be suspected in the presence of expansion defect-dropped lungs and massive air leakage despite tube thoracostomy in haemopneumothorax developing after thoracic trauma. Extracorporeal circulation-assisted tracheoplasty is a relatively safe option for children whose respiratory system is difficult to maintain, thus ensuring oxygenation ventilation and a clear surgical field.