Pub Date : 2024-04-01Epub Date: 2024-02-14DOI: 10.1089/lap.2023.0475
Diego Laurentino Lima, Raquel Nogueira, Jack Liu, Christiano Claus, Flavio Malcher, Prashanth Sreeramoju, Leandro Totti Cavazzola
ChatGPT is a conversational AI model developed by OpenAI to generate human-like text based on the input it receives. ChatGPT has become increasingly popular, and the general public may use this tool to ask questions about different medical conditions. There is a lack of data to demonstrate ChatGPT is able to provide reliable information on medical conditions. The aim of our study is to assess the accuracy and appropriateness of ChatGPT answers to questions on ventral hernia management.
{"title":"How Appropriate Are Recommendations of Online Chat-Based Artificial Intelligence (ChatGPT) to Common Questions on Ventral Hernia Repair?","authors":"Diego Laurentino Lima, Raquel Nogueira, Jack Liu, Christiano Claus, Flavio Malcher, Prashanth Sreeramoju, Leandro Totti Cavazzola","doi":"10.1089/lap.2023.0475","DOIUrl":"10.1089/lap.2023.0475","url":null,"abstract":"<p><p>ChatGPT is a conversational AI model developed by OpenAI to generate human-like text based on the input it receives. ChatGPT has become increasingly popular, and the general public may use this tool to ask questions about different medical conditions. There is a lack of data to demonstrate ChatGPT is able to provide reliable information on medical conditions. The aim of our study is to assess the accuracy and appropriateness of ChatGPT answers to questions on ventral hernia management.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aims: Retroperitoneoscopic simple nondismembered pyeloplasty (SNDP) with da Vinci Si assistance was developed because of a possible risk for alignment shift after retroperitoneoscopic diamond-shaped bypass pyeloplasty (Diamond-Bypass; DP). Outcomes of SNDP and DP were compared. Materials and Methods: For SNDP, a small longitudinal incision is made on the border of the dilated pelvis and narrowed ureter at the ureteropelvic junction (UPJ). Extending this incision toward the pelvis allows identification of mucosa while maintaining the integrity of surrounding tissues that are so thin and fragile that they will not influence lumen alignment. Data for DP were obtained from a previously published article. Results: For SNDP (n = 3), mean age at surgery was 2.67 years (range: 1-4), mean operative time was 176 minutes. Mean postoperative Society of Fetal Urology (SFU) grades for hydronephrosis were 1.2, 0.7, and 0.6, 1, 2, and 3 months after stent removal, respectively. Postoperative diethylenetriaminepentaacetic acid (DTPA) was normal (n = 3). For DP (n = 5) mean age at surgery was 4.3 years (range: 1-14), mean operative time was 189 minutes. Mean postoperative SFU grades were 2.8, 2.2, and 1.6, respectively. Postoperative DTPA was normal (n = 4) and delayed (n = 1). All SNDP and DP were asymptomatic by 3 months after stent removal. Conclusion: Both SNDP and DP have favorable outcomes. If the UPJ is located at the lowest end of the renal pelvis, SNDP may improve hydronephrosis more quickly.
{"title":"Retroperitoneoscopic Simple Nondismembered Pyeloplasty with Da Vinci Si Assistance to Prevent Alignment Shift.","authors":"Go Miyano, Hisae Iida, Yu Ebata, Eri Abe, Haruki Kato, Takafumi Mikami, Junya Ishii, Geoffrey J Lane, Atsuyuki Yamataka, Tadaharu Okazaki","doi":"10.1089/lap.2023.0236","DOIUrl":"10.1089/lap.2023.0236","url":null,"abstract":"<p><p><b><i>Aims:</i></b> Retroperitoneoscopic simple nondismembered pyeloplasty (SNDP) with da Vinci Si assistance was developed because of a possible risk for alignment shift after retroperitoneoscopic diamond-shaped bypass pyeloplasty (Diamond-Bypass; DP). Outcomes of SNDP and DP were compared. <b><i>Materials and Methods:</i></b> For SNDP, a small longitudinal incision is made on the border of the dilated pelvis and narrowed ureter at the ureteropelvic junction (UPJ). Extending this incision toward the pelvis allows identification of mucosa while maintaining the integrity of surrounding tissues that are so thin and fragile that they will not influence lumen alignment. Data for DP were obtained from a previously published article. <b><i>Results:</i></b> For SNDP (<i>n</i> = 3), mean age at surgery was 2.67 years (range: 1-4), mean operative time was 176 minutes. Mean postoperative Society of Fetal Urology (SFU) grades for hydronephrosis were 1.2, 0.7, and 0.6, 1, 2, and 3 months after stent removal, respectively. Postoperative diethylenetriaminepentaacetic acid (DTPA) was normal (<i>n</i> = 3). For DP (<i>n</i> = 5) mean age at surgery was 4.3 years (range: 1-14), mean operative time was 189 minutes. Mean postoperative SFU grades were 2.8, 2.2, and 1.6, respectively. Postoperative DTPA was normal (<i>n</i> = 4) and delayed (<i>n</i> = 1). All SNDP and DP were asymptomatic by 3 months after stent removal. <b><i>Conclusion:</i></b> Both SNDP and DP have favorable outcomes. If the UPJ is located at the lowest end of the renal pelvis, SNDP may improve hydronephrosis more quickly.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Despite the considerable studies conducted on the quality of YouTube surgical videos as an educational resource in other surgical fields, there have been no such studies in the field of laparoscopic urology so far. Considering the great sensitivity in these procedures and the necessity of identifying the mistakes in these videos, we aimed to evaluate the quality of YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries. Materials and Methods: In this descriptive cross-sectional study, 131 YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries were reviewed. Two researchers familiar with laparoscopic urological surgery reviewed the videos based on the LAP-VEGaS checklist. A third professor reviewed the videos on which there were disagreements. Results: In the majority of the videos, the title was chosen accordingly and the surgeon was introduced appropriately. Furthermore, in most of the videos, patient anonymity was respected. The mean score of the videos was equal to 74.3 ± 5.4, the maximum score being 17 and the minimum 1. The average score of the partial nephrectomy videos was obtained as 98.3 ± 5.74, whereas the average score for adrenalectomy videos was 47.3 ± 4.5. The overall average score of the studied videos was 74.3 ± 5.40. Conclusion: The results of our study suggest that most of YouTube videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries are used for educational purpose. These YouTube videos are suboptimal in educational aspect and students should be advised to use them with caution.
{"title":"Assessment of the Quality of YouTube Educational Videos on Laparoscopic Right Adrenalectomy and Laparoscopic Partial Nephrectomy Surgeries.","authors":"Seyed Alireza Hashemi, Behnam Shakiba, Alireza Golshan, Saeed Esmaeil Soofian, Robab Maghsoudi","doi":"10.1089/lap.2023.0433","DOIUrl":"10.1089/lap.2023.0433","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Despite the considerable studies conducted on the quality of YouTube surgical videos as an educational resource in other surgical fields, there have been no such studies in the field of laparoscopic urology so far. Considering the great sensitivity in these procedures and the necessity of identifying the mistakes in these videos, we aimed to evaluate the quality of YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries. <b><i>Materials and Methods:</i></b> In this descriptive cross-sectional study, 131 YouTube educational videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries were reviewed. Two researchers familiar with laparoscopic urological surgery reviewed the videos based on the LAP-VEGaS checklist. A third professor reviewed the videos on which there were disagreements. <b><i>Results:</i></b> In the majority of the videos, the title was chosen accordingly and the surgeon was introduced appropriately. Furthermore, in most of the videos, patient anonymity was respected. The mean score of the videos was equal to 74.3 ± 5.4, the maximum score being 17 and the minimum 1. The average score of the partial nephrectomy videos was obtained as 98.3 ± 5.74, whereas the average score for adrenalectomy videos was 47.3 ± 4.5. The overall average score of the studied videos was 74.3 ± 5.40. <b><i>Conclusion:</i></b> The results of our study suggest that most of YouTube videos on laparoscopic right adrenalectomy and laparoscopic partial nephrectomy surgeries are used for educational purpose. These YouTube videos are suboptimal in educational aspect and students should be advised to use them with caution.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Esophageal submucosal tumors (SMTs) are rare, occurring in less than 1% of esophageal neoplasms. For surgical treatment of esophageal SMTs, enucleation is usually the procedure of choice for benign tumors. This study aimed at evaluating the surgical technique and outcomes of thoracoscopic enucleation with esophagoscopy for esophageal SMTs. Methods: Patients with esophageal SMTs who underwent thoracoscopic enucleation between 2015 and 2022 were retrospectively investigated. Surgery was performed with the patient in the prone position. First, an esophagoscope was inserted, and a sodium hyaluronate solution with indigo carmine dye was injected into the submucosal layer just below the tumor. Next, under thoracoscopy, the tumor was exposed through a thoracoscopic incision and dissection of the muscularis propria and adventitia was performed at the tumor site. The colored layer resulting from the previously injected dye was identified, and tumor enucleation was performed under guidance of the dye so as not to damage the mucosa or pseudocapsule. Results: In total, 5 surgeries were performed. The mean operative time was 122.6 minutes (range 84-168 minutes), mean blood loss was 21.1 mL (range 0-80 mL), and mean postoperative hospital stay was 8 days (range 7-10 days). There were no postoperative complications. Pathological diagnosis revealed 2 cases of gastrointestinal stromal tumors, 2 cases of schwannoma, and 1 case of leiomyoma. Conclusions: We believe that this technique is a useful and safe method of performing thoracoscopic enucleation of esophageal SMTs because the injected dye provides an indicator of the resection line during enucleation.
{"title":"Analysis of Thoracoscopic Enucleation Combined with Esophagoscopy in the Prone Position for Esophageal Submucosal Tumor.","authors":"Shinya Mikami, Yasuhito Hisatsune, Masaki Hiwatari, Yoshitsugu Tsukamoto, Sae Kimura, Jin Shimada, Takeharu Enomoto, Osamu Saji, Takehito Otsubo","doi":"10.1089/lap.2023.0466","DOIUrl":"10.1089/lap.2023.0466","url":null,"abstract":"<p><p><b><i>Background:</i></b> Esophageal submucosal tumors (SMTs) are rare, occurring in less than 1% of esophageal neoplasms. For surgical treatment of esophageal SMTs, enucleation is usually the procedure of choice for benign tumors. This study aimed at evaluating the surgical technique and outcomes of thoracoscopic enucleation with esophagoscopy for esophageal SMTs. <b><i>Methods:</i></b> Patients with esophageal SMTs who underwent thoracoscopic enucleation between 2015 and 2022 were retrospectively investigated. Surgery was performed with the patient in the prone position. First, an esophagoscope was inserted, and a sodium hyaluronate solution with indigo carmine dye was injected into the submucosal layer just below the tumor. Next, under thoracoscopy, the tumor was exposed through a thoracoscopic incision and dissection of the muscularis propria and adventitia was performed at the tumor site. The colored layer resulting from the previously injected dye was identified, and tumor enucleation was performed under guidance of the dye so as not to damage the mucosa or pseudocapsule. <b><i>Results:</i></b> In total, 5 surgeries were performed. The mean operative time was 122.6 minutes (range 84-168 minutes), mean blood loss was 21.1 mL (range 0-80 mL), and mean postoperative hospital stay was 8 days (range 7-10 days). There were no postoperative complications. Pathological diagnosis revealed 2 cases of gastrointestinal stromal tumors, 2 cases of schwannoma, and 1 case of leiomyoma. <b><i>Conclusions:</i></b> We believe that this technique is a useful and safe method of performing thoracoscopic enucleation of esophageal SMTs because the injected dye provides an indicator of the resection line during enucleation.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study aimed to compare respiratory functions of patients after thoracoscopic lobectomy (TS) with those after thoracotomy (TR). Methods: This retrospective study was conducted in two centers, one of which adapted TS as a standard procedure in 2009 and the other performs it via TR. Data on patients who underwent lobectomy for congenital lung disease between 2009 and 2021 and underwent pulmonary function test (spirometry) were collected. Results: Ten patients underwent TS and 36 underwent TR. Distribution based on sex, prenatal diagnosis, pathological diagnosis, and resected lobe were similar between the two groups. The median [interquartile range] age at procedure in the TR group was significantly smaller than that in the TS group (13 [11-18] months versus 38 [13-79] months, P = .03). The procedure duration in the TR group was significantly shorter than that in the TS group (230 [171-264] minutes versus 264 [226-420] minutes, P = .02). Pulmonary function test was conducted at the age of eight in both groups, but the interval between the procedure, and the test was significantly shorter in the TS group (TR: 7 [5-8] years versus TS: 5 [2-7] years, P = .03). The ratio of forced vital capacity compared to predicted one (TR: 86.6 [76.6-95.3] versus TS: 88.7 [86.8-89.1], P = .58) and the ratio of forced expiratory volume in 1 second against that predicted (TR: 84.0 [80.5-88.7] versus TS: 88.7 [86.8-89.1], P = .08) were not significantly different between the two groups. Conclusions: Although TR was performed earlier than TS, respiratory function was similar between the two groups.
{"title":"Comparison of Postoperative Respiratory Function Between Patients After Thoracoscopic and Open Lobectomy.","authors":"Tetsuya Ishimaru, Yutaka Kanamori, Akihiro Fujino, Akihiro Yoneda, Michimasa Fujiogi, Yuki Yamamoto, Motohiro Kano, Goro Koinuma, Kyoichi Deie, Hiroshi Kawashima","doi":"10.1089/lap.2023.0244","DOIUrl":"10.1089/lap.2023.0244","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study aimed to compare respiratory functions of patients after thoracoscopic lobectomy (TS) with those after thoracotomy (TR). <b><i>Methods:</i></b> This retrospective study was conducted in two centers, one of which adapted TS as a standard procedure in 2009 and the other performs it via TR. Data on patients who underwent lobectomy for congenital lung disease between 2009 and 2021 and underwent pulmonary function test (spirometry) were collected. <b><i>Results:</i></b> Ten patients underwent TS and 36 underwent TR. Distribution based on sex, prenatal diagnosis, pathological diagnosis, and resected lobe were similar between the two groups. The median [interquartile range] age at procedure in the TR group was significantly smaller than that in the TS group (13 [11-18] months versus 38 [13-79] months, <i>P</i> = .03). The procedure duration in the TR group was significantly shorter than that in the TS group (230 [171-264] minutes versus 264 [226-420] minutes, <i>P</i> = .02). Pulmonary function test was conducted at the age of eight in both groups, but the interval between the procedure, and the test was significantly shorter in the TS group (TR: 7 [5-8] years versus TS: 5 [2-7] years, <i>P</i> = .03). The ratio of forced vital capacity compared to predicted one (TR: 86.6 [76.6-95.3] versus TS: 88.7 [86.8-89.1], <i>P</i> = .58) and the ratio of forced expiratory volume in 1 second against that predicted (TR: 84.0 [80.5-88.7] versus TS: 88.7 [86.8-89.1], <i>P</i> = .08) were not significantly different between the two groups. <b><i>Conclusions:</i></b> Although TR was performed earlier than TS, respiratory function was similar between the two groups.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The aim of this study is to compare the precision and applicability of the Zhongshan (ZS) score against the radius, exophytic/endophytic, nearness, anterior/posterior, and location (RENAL) score in forecasting perioperative outcomes during laparoscopic partial nephrectomy (LPN). Materials and Methods: We retrospectively analyzed data from 99 renal cancer patients who underwent LPN between January 2017 and August 2023. Patients were scored and categorized based on both the ZS and RENAL scores. The study then compared perioperative outcomes across these groups and further investigated the correlation between ZS and RENAL scores and overall complication rates. Results: LPN was successfully accomplished in 94 patients, whereas 5 patients necessitated conversion to open or radical surgery. The high-risk group, according to the ZS score, manifested more warm ischemic time (WIT) than the low-risk group (P = .007). Furthermore, the incidence of overall complications escalated with increase in the ZS score grade (P = .045). A higher RENAL score corresponded to a greater risk of conversion to open or radical treatment (P = .012). Correlation analyses revealed associations between both ZS and RENAL scores and overall complications. The RENAL score also correlated with changes in blood creatinine values, while the ZS score was associated with WIT (all P < .05). In the univariate analysis, both ZS and RENAL scores were substantial factors for the occurrence of total complications (P = .029 and P = .027, respectively), but they were not statistically significant in the multivariate analysis. The receiver operating characteristic curves suggested that both individual and combined ZS and RENAL scores held predictive potential for the onset of overall complications (area under the curve = 0.652, 0.660, and 0.676, respectively). Conclusions: Compared with the RENAL score, the ZS score provides a more comprehensive assessment of tumor complexity in patients undergoing LPN. Integrating these two scores could potentially improve the accuracy of predicting surgical risks.
{"title":"Performance Prediction for Surgical Outcomes in Laparoscopic Partial Nephrectomy Using Nephrometry Scores: A Comparison of Zhongshan and Radius, Exophytic/Endophytic, Nearness, Anterior/Posterior, Location Systems.","authors":"Yang Hu, Shiyu Huang, Cici Guo, Guangyi Hong, Yikun Wu, Shuxiong Xu","doi":"10.1089/lap.2023.0502","DOIUrl":"10.1089/lap.2023.0502","url":null,"abstract":"<p><p><b><i>Objective:</i></b> The aim of this study is to compare the precision and applicability of the Zhongshan (ZS) score against the radius, exophytic/endophytic, nearness, anterior/posterior, and location (RENAL) score in forecasting perioperative outcomes during laparoscopic partial nephrectomy (LPN). <b><i>Materials and Methods:</i></b> We retrospectively analyzed data from 99 renal cancer patients who underwent LPN between January 2017 and August 2023. Patients were scored and categorized based on both the ZS and RENAL scores. The study then compared perioperative outcomes across these groups and further investigated the correlation between ZS and RENAL scores and overall complication rates. <b><i>Results:</i></b> LPN was successfully accomplished in 94 patients, whereas 5 patients necessitated conversion to open or radical surgery. The high-risk group, according to the ZS score, manifested more warm ischemic time (WIT) than the low-risk group (<i>P</i> = .007). Furthermore, the incidence of overall complications escalated with increase in the ZS score grade (<i>P</i> = .045). A higher RENAL score corresponded to a greater risk of conversion to open or radical treatment (<i>P</i> = .012). Correlation analyses revealed associations between both ZS and RENAL scores and overall complications. The RENAL score also correlated with changes in blood creatinine values, while the ZS score was associated with WIT (all <i>P</i> < .05). In the univariate analysis, both ZS and RENAL scores were substantial factors for the occurrence of total complications (<i>P</i> = .029 and <i>P</i> = .027, respectively), but they were not statistically significant in the multivariate analysis. The receiver operating characteristic curves suggested that both individual and combined ZS and RENAL scores held predictive potential for the onset of overall complications (area under the curve = 0.652, 0.660, and 0.676, respectively). <b><i>Conclusions:</i></b> Compared with the RENAL score, the ZS score provides a more comprehensive assessment of tumor complexity in patients undergoing LPN. Integrating these two scores could potentially improve the accuracy of predicting surgical risks.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Ensuring patient safety in minimally invasive surgery (MIS) within the field of pediatric surgery requires systematic and extensive practice. Many groups have proposed mastery learning programs encompassing a range of training methods. However, short courses often have a narrow focus on specific objectives, limiting opportunities for sustained training. Our aim was to analyze our results with an online long-term competency-based and supervised training. Methods: This is a retrospective cohort study with prospective data collection of scores and performance of trainees during online courses from October 2020 to April 2023. Results: All participants (n = 76) were able to set up their personal training gym and complete the intensive stage of the course. The total score evolved from 2.60 ± 0.56 at the first meeting to 3.67 ± 0.61 at the fourth meeting, exhibiting a significant difference (P < .013). A considerable drop out was observed in the follow-up stage, with only 53.8% of the participants completing the course. When compared with the first meeting, they also showed a significant improvement with a mean general score of 3.85 ± 0.25 (P < .013) Conclusion: We have presented a novel online training program, based on continuous training that demonstrated that the unlimited access to a personal training gym allows surgeons to improve and maintain MIS skills.
导言:确保小儿外科领域微创手术(MIS)的患者安全需要系统而广泛的实践。许多团体提出了包含一系列培训方法的掌握学习计划。然而,短期课程往往只关注特定目标,限制了持续培训的机会。我们的目的是分析在线长期能力为基础和监督培训的结果。培训方法这是一项回顾性队列研究,前瞻性地收集了学员在 2020 年 10 月至 2023 年 4 月在线课程期间的分数和表现数据。研究结果所有学员(n = 76)都能建立个人训练馆并完成课程的强化阶段。总分从第一次会议的 2.60±0.56 分上升到第四次会议的 3.67±0.61 分,差异显著(P P 结论:我们提出了一种新颖的在线培训计划:我们介绍了一种基于持续培训的新型在线培训计划,该计划表明,外科医生可以无限制地访问个人培训健身房,从而提高并保持 MIS 技能。
{"title":"Results of a Novel Long-Term Method for Laparoscopic Skills Online Training.","authors":"Cecilia Gigena, Ignacio Díaz, Soledad Valverde, Agustina Mariana Portu, Ana Clara Fortunato, Ruth Kaller, Mariano Bosich, Gastón Bellía Munzon, Carolina Millán","doi":"10.1089/lap.2023.0464","DOIUrl":"https://doi.org/10.1089/lap.2023.0464","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Ensuring patient safety in minimally invasive surgery (MIS) within the field of pediatric surgery requires systematic and extensive practice. Many groups have proposed mastery learning programs encompassing a range of training methods. However, short courses often have a narrow focus on specific objectives, limiting opportunities for sustained training. Our aim was to analyze our results with an online long-term competency-based and supervised training. <b><i>Methods:</i></b> This is a retrospective cohort study with prospective data collection of scores and performance of trainees during online courses from October 2020 to April 2023. <b><i>Results:</i></b> All participants (<i>n</i> = 76) were able to set up their personal training gym and complete the intensive stage of the course. The total score evolved from 2.60 ± 0.56 at the first meeting to 3.67 ± 0.61 at the fourth meeting, exhibiting a significant difference (<i>P</i> < .013). A considerable drop out was observed in the follow-up stage, with only 53.8% of the participants completing the course. When compared with the first meeting, they also showed a significant improvement with a mean general score of 3.85 ± 0.25 (<i>P</i> < .013) <b><i>Conclusion:</i></b> We have presented a novel online training program, based on continuous training that demonstrated that the unlimited access to a personal training gym allows surgeons to improve and maintain MIS skills.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140208105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Modified Anderson-Hynes pyeloplasty is currently preferred for ureteropelvic junction obstruction (UPJO). Extravasation of urine and anastomotic stenosis are the most common complications after Anderson-Hynes pyeloplasty, which are closely linked with the technique for anastomosis. However, there are currently no clear guidelines for the suture bite depth in suturing the anastomosis during pyeloplasty. Objective: To analyze the optimal suture bite depth in laparoscopic Anderson-Hynes pyeloplasty. Study Design: A total of 90 children aged 4-14 years with UPJO-induced hydronephrosis who were surgically treated in the First People's Hospital of Lianyungang from July 2019 to July 2022 were prospectively recruited. All received laparoscopic Anderson-Hynes pyeloplasty using 5-0 Vicryl continuous sutures. According to the suture bite depth, the patients were divided into group A (depth 1 mm, n = 46) and group B (depth 0.5 mm, n = 44). Operation time, postoperative drainage volume, time of ureteral stent removal, incidence of postoperative complications, and time to hydronephrosis resolution were compared between groups. Results: Group A showed significantly less postoperative drainage volume, and shorter time of ureteral stent removal and hydronephrosis resolution (all P < .05). Four cases in group B received replacement of a double-J stent. Except for 1 patient receiving reoperation for anastomotic stenosis caused by massive extravasation of urine, the replaced double-J stent was successfully removed from the remaining 3 patients at 3 months, and the symptoms of anastomotic stenosis disappeared. No significant difference was detected in the operation time between groups (P > .05). Conclusion: An appropriate deeper suture bite depth for anastomosis may reduce postoperative urine extravasation and related complications in children who received laparoscopic pyeloplasty for UPJO-induced hydronephrosis.
背景:目前,改良安德森-海因斯肾盂成形术是治疗输尿管肾盂连接处梗阻(UPJO)的首选方法。尿液外渗和吻合口狭窄是 Anderson-Hynes 肾盂成形术后最常见的并发症,这与吻合技术密切相关。然而,目前对肾盂成形术中缝合吻合口时的缝线咬合深度还没有明确的指导原则。目的分析腹腔镜 Anderson-Hynes 肾盂成形术的最佳缝合咬合深度。研究设计:前瞻性招募2019年7月至2022年7月在连云港市第一人民医院接受手术治疗的90名4-14岁UPJO诱发肾积水患儿。所有患者均接受了腹腔镜安德森-海因斯肾盂成形术,使用 5-0 Vicryl 连续缝合线。根据缝线咬合深度,将患者分为A组(深度1毫米,n=46)和B组(深度0.5毫米,n=44)。比较两组患者的手术时间、术后引流量、拔除输尿管支架时间、术后并发症发生率以及肾积水消退时间。结果显示A 组术后引流量明显减少,输尿管支架取出时间和肾积水消退时间明显缩短(所有 P P > .05)。结论对于接受腹腔镜肾盂成形术治疗 UPJO 引起的肾积水的儿童,吻合时适当加深缝合深度可减少术后尿液外渗和相关并发症。
{"title":"The Optimal Suture Bite Depth in Laparoscopic Pyeloplasty: A Comparative Study in Children.","authors":"Shaodong Gu, Hong Luo","doi":"10.1089/lap.2023.0434","DOIUrl":"https://doi.org/10.1089/lap.2023.0434","url":null,"abstract":"<p><p><b><i>Background:</i></b> Modified Anderson-Hynes pyeloplasty is currently preferred for ureteropelvic junction obstruction (UPJO). Extravasation of urine and anastomotic stenosis are the most common complications after Anderson-Hynes pyeloplasty, which are closely linked with the technique for anastomosis. However, there are currently no clear guidelines for the suture bite depth in suturing the anastomosis during pyeloplasty. <b><i>Objective:</i></b> To analyze the optimal suture bite depth in laparoscopic Anderson-Hynes pyeloplasty. <b><i>Study Design:</i></b> A total of 90 children aged 4-14 years with UPJO-induced hydronephrosis who were surgically treated in the First People's Hospital of Lianyungang from July 2019 to July 2022 were prospectively recruited. All received laparoscopic Anderson-Hynes pyeloplasty using 5-0 Vicryl continuous sutures. According to the suture bite depth, the patients were divided into group A (depth 1 mm, <i>n</i> = 46) and group B (depth 0.5 mm, <i>n</i> = 44). Operation time, postoperative drainage volume, time of ureteral stent removal, incidence of postoperative complications, and time to hydronephrosis resolution were compared between groups. <b><i>Results:</i></b> Group A showed significantly less postoperative drainage volume, and shorter time of ureteral stent removal and hydronephrosis resolution (all <i>P</i> < .05). Four cases in group B received replacement of a double-J stent. Except for 1 patient receiving reoperation for anastomotic stenosis caused by massive extravasation of urine, the replaced double-J stent was successfully removed from the remaining 3 patients at 3 months, and the symptoms of anastomotic stenosis disappeared. No significant difference was detected in the operation time between groups (<i>P</i> > .05). <b><i>Conclusion:</i></b> An appropriate deeper suture bite depth for anastomosis may reduce postoperative urine extravasation and related complications in children who received laparoscopic pyeloplasty for UPJO-induced hydronephrosis.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2023-10-12DOI: 10.1089/lap.2023.0299
Yao Liu, Francois I Luks
Introduction: Innovation is not a straightforward path. While surgeons are intimately familiar with clinical problems and often devise clever solutions to address them, the journey from idea to a marketable product is opaque. We describe our experience developing a novel video navigation system to help streamline collaboration and enhance surgeon control of their video image in minimally invasive surgery. Materials and Methods: Our idea began with recognizing the primary clinical challenge: "one bad image for all" in laparoscopic surgery, when the least experienced member of the surgical team is often expected to hold the camera. Results: Through multiple iterations and pivots, including hardware-based solutions like head-mounted displays and individualized monitors, we arrived at a hardware-agnostic software algorithm to process laparoscopic video for real-time image navigation. As we explain why, how, and when to pivot, we provide brief overviews of protecting intellectual property and financing innovation. Finally, collaboration with professional societies, such as the International Pediatric Endosurgery Group, provides fertile testing grounds for new ideas. Conclusion: Our experience may help future surgeon-innovators go from their ideas to industry-ready.
{"title":"Driver-Activated VIDeoscopic Surgery: An Innovation Journey from Idea to Industry-Ready.","authors":"Yao Liu, Francois I Luks","doi":"10.1089/lap.2023.0299","DOIUrl":"10.1089/lap.2023.0299","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Innovation is not a straightforward path. While surgeons are intimately familiar with clinical problems and often devise clever solutions to address them, the journey from idea to a marketable product is opaque. We describe our experience developing a novel video navigation system to help streamline collaboration and enhance surgeon control of their video image in minimally invasive surgery. <b><i>Materials and Methods:</i></b> Our idea began with recognizing the primary clinical challenge: \"one bad image for all\" in laparoscopic surgery, when the least experienced member of the surgical team is often expected to hold the camera. <b><i>Results:</i></b> Through multiple iterations and pivots, including hardware-based solutions like head-mounted displays and individualized monitors, we arrived at a hardware-agnostic software algorithm to process laparoscopic video for real-time image navigation. As we explain why, how, and when to pivot, we provide brief overviews of protecting intellectual property and financing innovation. Finally, collaboration with professional societies, such as the International Pediatric Endosurgery Group, provides fertile testing grounds for new ideas. <b><i>Conclusion:</i></b> Our experience may help future surgeon-innovators go from their ideas to industry-ready.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-01Epub Date: 2024-01-22DOI: 10.1089/lap.2023.0455
ShiGuai Qi, Jie Tao, Xinhua Wu, Xu Feng, Guoying Feng, Zhengrong Shi
Purpose: To analyze the related factors of portal vein thrombosis (PVT) after hepatectomy. Methods: A retrospective analysis was made on 1029 patients who underwent partial hepatectomy in the first affiliated Hospital of Chongqing Medical University from March 2018 to March 2023, including PVT group (n = 24) and non-PVT group (n = 1005). The general and clinical data of the two groups were collected. Univariate and multivariate logistic regression analysis was used to analyze the clinical information of the two groups. Result: The proportion of preoperative hepatitis B, liver cirrhosis, ascites, intraoperative blood transfusion, postoperative hemostatic drugs, preoperative prothrombin time, intraoperative portal occlusion time, operation time, international standardized ratio of prothrombin time on the first day after operation, D-dimer on the first day after operation, fibrin degradation products on the first day after operation and postoperative hospital stay in the PVT group were all higher than those in the control group (P < .05). The preoperative platelet and albumin in the PVT group were lower than those in the control group. Intraoperative blood transfusion, liver cirrhosis, ascites, international standardized ratio of postoperative prothrombin time, postoperative fibrin degradation products, hilar occlusion time and albumin were independent risk factors for PVT. Conclusion: There are many influencing factors of PVT after hepatectomy. Clinical intervention should be taken to reduce PVT. Clinical Registration Number: K2023-348.
{"title":"Analysis of Related Influencing Factors of Portal Vein Thrombosis After Hepatectomy.","authors":"ShiGuai Qi, Jie Tao, Xinhua Wu, Xu Feng, Guoying Feng, Zhengrong Shi","doi":"10.1089/lap.2023.0455","DOIUrl":"10.1089/lap.2023.0455","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> To analyze the related factors of portal vein thrombosis (PVT) after hepatectomy. <b><i>Methods:</i></b> A retrospective analysis was made on 1029 patients who underwent partial hepatectomy in the first affiliated Hospital of Chongqing Medical University from March 2018 to March 2023, including PVT group (<i>n</i> = 24) and non-PVT group (<i>n</i> = 1005). The general and clinical data of the two groups were collected. Univariate and multivariate logistic regression analysis was used to analyze the clinical information of the two groups. <b><i>Result:</i></b> The proportion of preoperative hepatitis B, liver cirrhosis, ascites, intraoperative blood transfusion, postoperative hemostatic drugs, preoperative prothrombin time, intraoperative portal occlusion time, operation time, international standardized ratio of prothrombin time on the first day after operation, D-dimer on the first day after operation, fibrin degradation products on the first day after operation and postoperative hospital stay in the PVT group were all higher than those in the control group (<i>P</i> < .05). The preoperative platelet and albumin in the PVT group were lower than those in the control group. Intraoperative blood transfusion, liver cirrhosis, ascites, international standardized ratio of postoperative prothrombin time, postoperative fibrin degradation products, hilar occlusion time and albumin were independent risk factors for PVT. <b><i>Conclusion:</i></b> There are many influencing factors of PVT after hepatectomy. Clinical intervention should be taken to reduce PVT. Clinical Registration Number: K2023-348.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}