Innovative Surgical Sciences最新文献

The acquisition of surgical skills in highly specialized pediatric surgical procedures - particularly the management of rare congenital anomalies - poses significant educational challenges. Traditional training models relying on apprenticeship and intraoperative exposure are often insufficient due to the rarity and complexity of such conditions. Simulation-based training offers a structured, reproducible, and risk-free environment to practice and refine surgical techniques. This scoping review examines the current landscape of simulation in pediatric surgery, focusing on anorectal malformations (ARM), esophageal atresia (EA), Hirschsprung's disease (HD) and congenital diaphragmatic hernia (CDH). A dual search strategy was applied: a systematic literature search via PubMed and a structured online search via Google for commercially available simulation models. A range of models was identified across the four index conditions, including low-fidelity, high-fidelity, hybrid, and animal tissue-based simulators. EA and CDH showed the highest diversity in simulation tools, supporting both open and minimally invasive approaches. Several of the models we identified have demonstrated face, content and construct validity, but systematic data on learning outcomes and user satisfaction remain scarce. While low-fidelity models are useful for basic skill acquisition, high-fidelity and hybrid simulations more closely replicate the operative environment and enhance decision-making and technical proficiency. However, access to high-fidelity simulators remains limited due to cost and resource constraints. By identifying current limitations and opportunities of simulation training, this scoping review provides insights into how the sustainable training of the next generation of pediatric surgeons can be mastered.

Pelvic insufficiency fractures (PIFs) are low-energy fractures typically occurring in osteoporotic bone and are associated with significant morbidity, reduced quality of life, and increased mortality. PIF requires individualized, often interdisciplinary treatment strategies combining surgical, conservative, and systemic approaches. This narrative review aims to summarize recent findings on the diagnosis, management, and outcomes of PIFs and place them in the context of existing literature. For this purpose, a selective literature search was conducted in January 2025 to identify publications on the topic of PIFs. The search was performed on PubMed and clinical studies addressing the diagnosis, treatment, outcomes and complications of PIFs from January 2024 to 2025 were selected for evaluation. A total of 11 studies with a total of 27,672 patients were included in this review. The findings emphasise the significant morbidity, mortality and healthcare burden associated with these fractures. Conventional radiography frequently fails to detect this type of fracture, thus necessitating advanced imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) to ensure an early diagnosis. The treatment decision is determined by the stability of the fracture, presence and intensity of pain, and the patient's mobility levels. The treatment options, whether conservative or surgical, are adapted to these factors. The osteoporotic fracture (OF) Pelvis Score has emerged as a promising tool for guiding therapeutic strategies, though there is still potential for further development in the use of pharmaceutical treatment of underlying conditions such as osteoporosis. Despite the advances that have been made, the existing literature remains heterogeneous, underscoring the importance of conducting prospective studies and developing evidence-based guidelines. Interdisciplinary and orthogeriatric care is important for improving outcomes for this vulnerable patient group.

Introduction: Pancreatic resections are one of the most complex operations in visceral surgery, characterized by high perioperative morbidity and mortality. Continuous evaluation and adjustment of surgical techniques and approaches are required to improve the quality of surgery and outcomes in this highly vulnerable collective of patients.

Content: In this short narrative review we will discuss exemplary three recent advances in pancreatic surgery.

Summary and outlook: A systematic literature search was performed using the PubMed database. The three discussed promising developments in pancreatic surgery are the triangle operation, a radical resection of lymphatic and nerve tissue in patients with pancreatic cancer, autologous patches for covering skeletonized arteries after resection to reduce frequent postoperative complications, and minimal invasive surgical approaches, which offer potential benefits in reduced intraoperative blood loss, shorter hospital stay and lower rate of wound infections compared to open resections. These three new operative approaches represent promising advances in a demanding surgical field. However, further studies are needed to confirm the benefits of these techniques on patient outcomes.

Introduction: The vast majority of people are affected by tooth loss in the course of their lives. Dental implants are used to anchor prosthetic teeth and represent the gold standard for replacing missing teeth. As the preservation of chewing function and esthetics has a significant influence on the quality of life, the constant further development of techniques and materials is a central issue in oral and maxillofacial surgery. This narrative review article aims to evaluate the historical development, current status, and innovative methods of dental implants.

Content: A selective literature search based on Pubmed was conducted, focusing primarily on literature from the years 2023 to 2025. Keywords used in the search were "dental implants" in combination with "navigation" and "virtual surgical planning."

Summary: The causes of tooth loss, the anatomical conditions of the jaw, and possible treatment approaches for oral rehabilitation are diverse and require individual consideration depending on the individual patient situation. In any case, the use of materials and geometries supporting the osseointegration of the implants, the optimal positioning of the implants in the jawbone, and surgery procedures that are as atraumatic as possible are fundamental to successful implantation. In recent years, digital and technical innovations have changed the way treatment is planned and performed. The shift toward an increasingly digital workflow has resulted in more efficient planning and improved precision in implant positioning. This is associated with improved clinical results and more satisfied patients.

Outlook: In this study, the field of dental implantology is reviewed and future opportunities and challenges are identified. Despite the fact that this will result in new obstacles, dental implantation can become increasingly precise and efficient thanks to the development of digital technologies such as Augmented Reality-Assisted Navigation and autonomous dental implant robots.

Objective: Virtual reality (VR) simulators are considered a promising tool for significantly enhancing surgical skills. This study aims to compare the use of a VR simulator with a conventional phantom model in oral surgery training. The findings should contribute to the further development of oral surgery simulation training and help maximize the innovative benefits of VR-based training.

Methods: This prospective, cross-sectional, single center study analyzed students' competence in performing an osteotomy on a displaced tooth 38. Participants were dental students in their 5th semester at a University Medical Center in Germany. The study compared a VR simulator with a phantom model. After completing the exercise, students filled out a questionnaire consisting of both standardized and open-ended questions to allow for a comprehensive subjective evaluation of the training experience.

Results: A total of 22 students took part in the study (12 female, 10 male). None had previously performed the exercise on a patient. From the students' perspective, both training methods were easy to learn (VR:2.0; Ph: 2.1; p=0.642). Individual feedback highlighted that the VR simulator's main advantages were sustainability (n=12) and objectivity (n=5). However, standardized responses indicated that the phantom model was rated as more realistic, particularly regarding anatomical representation (p<0.001), haptic feedback (p<0.001) tooth removal (p<0.001) and osteotomy steps (p<0.001). Both exercises were equally engaging for students (VR:1.8; Ph:1.5; p=0.162).

Conclusion: Simulation-based training is an engaging way for students to learn surgical tooth removal. Currently, conventional simulation is subjectively perceived as superior to VR simulation, particularly in terms of realism. However, VR simulation allows for a more objective assessment of performance and is considered superior to the phantom model in terms of sustainability. Further technological advancements and improvements in realism could help maximize the innovative benefits of VR-based training.

Objectives: The presence of heterotopic pancreatic tissue or malacoplakia in the liver is very uncommon and rarely becomes symptomatic.

Case presentation: Here we report of a 57-year-old female patient who received left-sided hemihepatectomy due to a tumor resembling intrahepatic abscess. Histopathological examination revealed both heterotopic pancreas and malakoplakia.

Conclusions: We discuss this case in relation to the existing literature. As far as we know, this is the first reported case of simultaneous presence of these two rare entities.