Surgery open science最新文献

{"title":"Immersive collaborative virtual reality for case-based graduate student teaching in thoracic surgery: A piloting study","authors":"","doi":"10.1016/j.sopen.2024.10.008","DOIUrl":"10.1016/j.sopen.2024.10.008","url":null,"abstract":"<div><h3>Background</h3><div>In medical education various non-digital teaching methods are established. However, studies have proven that the immersive character of virtual reality (VR) applications positively impact the understanding of spatial relationships.</div><div>This study outlines the development and pilot testing of a novel system for collaborative, case-based VR teaching, utilizing real-time volume rendered computed tomography (CT) data of thoracic cases among graduate students.</div></div><div><h3>Methods</h3><div>A system was configured and deployed to provide real-time volume rendered CT data in a collaborative, multiuser VR environment. A thoracic surgery VR course was implemented into the surgical graduate curriculum, which has subsequently been evaluated with questionnaires.</div></div><div><h3>Results</h3><div>Seventy students assessed the curriculum through a questionnaire. Usability was rated intuitive (77.14 %) while few students (5.71 %) reported cyber sickness.</div><div>A vast majority (98.57 %) agreed VR improved their understanding of anatomy compared to traditional methods and most students found learning more effective. (88.57 %) and joy during participation was rated high (97,14 %). A majority of the students (61.43 %) believed VR could partly replace traditional methods. They supported integrating VR into preclinical (81.43 %) and clinical teaching (94.29 %) as well as taking VR courses from home (78.57 %). Most participants (90,72 %) encouraged the expansion of VR infrastructure.</div></div><div><h3>Conclusion</h3><div>The concept of a collaborative real-time VR-based educational program in medical graduate teaching has proven its technical feasibility and positive acceptance with a desire for more VR integration in surgical curricula. A two-armed study will be conducted to evaluate the objective impact as the expansion of VR environments for teaching continues.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid liver graft implantation in canine: A preliminary study","authors":"","doi":"10.1016/j.sopen.2024.10.006","DOIUrl":"10.1016/j.sopen.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>The current method for liver graft implantation during the anhepatic phase is complex. Therefore, this study aimed to introduce a modified orthotopic liver transplantation (OLT) technique with major vascular reconstruction using cuff technique to simplify the process of liver graft implantation during the anhepatic phase.</div></div><div><h3>Methods</h3><div>Twenty-four canines were randomly assigned to two groups: the modified orthotopic liver transplantation group (M-OLT, <em>n</em> = 12) and the control group (n = 12). All animals were randomly assigned to the donor or recipient groups. The recipients received orthotopic liver transplantation using a modified technique in the M-OLT group, and OLT using traditional implantation technique without venovenous bypass was performed in the control group. The donor and recipient characteristics were compared between the two groups. Vascular anastomotic patency was evaluated using angiography immediately and one week after surgery.</div></div><div><h3>Results</h3><div>All recipients underwent successful liver transplantation. There were no significant differences between the two groups in terms of sex, body weight, or cold ischemia time of the donor liver. However, recipients in the M-OLT group had a shorter operation time, less intraoperative blood loss, shorter anhepatic phase, shorter vascular occlusion time, and shorter warm ischemia time than that in the control group (all <em>p</em> &lt; 0.05). No anastomotic leakage or stenosis was detected in either group after liver transplantation. One recipient in the M-OLT group and three in the control group died within one week of transplantation.</div></div><div><h3>Conclusions</h3><div>This modified technique is safe and feasible for canine liver transplantation and can significantly simplify liver graft implantation procedures during the anhepatic period.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for cancer-specific survival of lung adenocarcinoma patients: A SEER based analysis","authors":"","doi":"10.1016/j.sopen.2024.10.003","DOIUrl":"10.1016/j.sopen.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Non-small cell lung cancer (NSCLC) accounts for 85 % of lung cancer cases. Among NSCLC subtypes, lung adenocarcinoma (LUAD) stands as the most prevalent. Regrettably, LUAD continues to exhibit a notably unfavorable overall prognosis. This study's primary aim was to develop and validate prognostic tools capable of predicting the likelihood of cancer-specific survival (CSS) in patients with LUAD.</div></div><div><h3>Methods</h3><div>We retrospectively collected 21,099 patients diagnosed with LUAD between 2010 and 2015, and 8290 patients diagnosed between 2004 and 2009 from SEER database. The cohort of 21,099 patients served as the prognostic group for the exploration of LUAD-related prognostic risk factors. The cohort of 8290 patients was designated for external validation. We created a training set and an internal validation set in the prognostic group for the development and internal validation of CSS nomograms. CSS predictors were identified through the least absolute shrinkage and selection operator (Lasso) regression analysis. Prognostic model was constructed via Cox hazard regression analysis, presented in the form of both static and dynamic network-based nomograms.</div></div><div><h3>Results</h3><div>Several independent prognostic factors were incorporated into the construction of nomogram. The nomogram accurately predicted CSS at 1, 3, and 5 years, with respective AUC values of 0.769, 0.761, and 0.748 for the training group, and 0.741, 0.752, and 0.740 for the testing group. The study demonstrated a strong agreement between anticipated and actual CSS values, supported by decision curve analysis (DCA) and time-dependent calibrated curves. High-risk patients based on the nomogram exhibiting significantly lower survival rates compared to their low-risk counterparts according to Kaplan-Meier (K-M) curves. The nomogram demonstrates excellent predictive power in the external validation cohort.</div></div><div><h3>Conclusions</h3><div>A dependable and user-friendly nomogram has been developed, available in both static and online dynamic calculator formats, to facilitate healthcare professionals in accurately estimating the likelihood of CSS for patients diagnosed LUAD.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation and self-assessment of liver transplantation training physicians at Shanghai Renji Hospital: A preliminary study","authors":"","doi":"10.1016/j.sopen.2024.10.004","DOIUrl":"10.1016/j.sopen.2024.10.004","url":null,"abstract":"<div><h3>Background</h3><div>Continuing medical education in liver transplantation is pivotal in enhancing the proficiency of liver surgeons. The goal of this study is to obtain information on all aspects of the training, enable us to pinpoint the training's strengths, and address any shortcomings or challenges.</div></div><div><h3>Method</h3><div>We conducted an online questionnaire survey, which was comprised of 33 questions, offering response options in the form of “yes/no”, single choice, or multiple choice.</div></div><div><h3>Results</h3><div>A total of 59 liver surgeons actively participated in the questionnaire survey. The majority of them exhibited a comprehensive understanding of the liver transplant training program, encompassing its structure, content, and assessment format. It is noteworthy that all respondents expressed keen interest in novel course components such as medical humanities, interpersonal communication, full-process patient management, and scientific research and academic activities. The overall satisfaction with the diverse specialized training courses was notably high. Furthermore, there was a significant improvement in self-confidence among participants for performing relevant clinical practices post-training, signifying the effectiveness of the program. Notably, key determinants influencing physicians' confidence levels before and after training included accumulated clinical practice time, basic operation cases, and educational background.</div></div><div><h3>Conclusion</h3><div>This survey reveals that trainees possess a commendable grasp of the program, maintain a positive outlook, and gain substantial benefits from the training. Importantly, it underscores the need to enhance the pedagogical skills of professional training instructors, continually refine the curriculum, and serve as a foundation for informed decisions in the ongoing training of liver transplant physicians.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the role of scrub nurses during robotic surgery console time","authors":"","doi":"10.1016/j.sopen.2024.10.001","DOIUrl":"10.1016/j.sopen.2024.10.001","url":null,"abstract":"<div><div>At our institution, scrub nurses leave the surgical field during the console time for robotic surgeries to attend to other duties. The first assistant then assumes their responsibilities, allowing for efficient use of staff time and resources. This practice improves teamwork and can be presented as a cost-saving measure for hospital administrations.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Woman or surgeon – Not both: Perceptions of support, enablers and barriers in general surgery","authors":"","doi":"10.1016/j.sopen.2024.10.002","DOIUrl":"10.1016/j.sopen.2024.10.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The General Surgery (GS) educational community of practice faces crisis. Recruitment is challenged by cultural norms of postponing post-foundation training; and retention with perceptions of elitism, discrimination and inflexibility (UK Shape of Training Steering Group, 2017; Kennedy, 2021) [<span><span>1</span></span>,<span><span>45</span></span>]. Surgical pedagogy has been examined through skill acquisition but what of the hidden curriculum (Brown et al., 2019) [<span><span>26</span></span>]. Three research aims were posed: who is a General Surgeon, what are the enablers or barriers to pursuing this career and is our current UK training system fit for purpose.</div></div><div><h3>Methods</h3><div>Qualitative methodology within a constructivist research paradigm was utilised. Recruitment included representative sampling of junior doctors, including men, women and those from diverse ethnic backgrounds. Individual semi-structured interviews explored participant perspectives of training, recruitment and work-life balance. Data was transcribed, familiarised, de-constructed and generated. Latent data analysis, coding and development, maintained reflexivity. ‘Data sets’ were transformed to a thematic map and key themes identified.</div></div><div><h3>Results and discussion</h3><div>Foundation, specialty doctors, core and higher surgical trainees were included (60 % men, 40 % women). Fundamental themes of support, attitudes and sacrifice were identified, interacting to influence educational narrative. Support comprised personal, institutional, academic and cultural forms. Attitudes of elitism, implicit and explicit gender bias, microaggressions and overt discrimination concealed as surgical tradition. An overarching concept of sacrifice was noted: personal, professional, fiscal and emotional, the so-called surgical currency.</div></div><div><h3>Conclusions</h3><div>The study explored phenotype, motivation, intellect and philosophy within GS. Highlighting issues in the system surrounding negative attitudes, cultures and behaviours, education is a powerful tool which can be used to challenge perceptions and improve training.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical instrument tray optimization process at a university hospital: A comprehensive overview","authors":"","doi":"10.1016/j.sopen.2024.09.007","DOIUrl":"10.1016/j.sopen.2024.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>This study presents the results of a surgical instrument tray optimization process implemented across all surgical specialties within the largest university hospital in Denmark.</div></div><div><h3>Methods</h3><div>Data was extracted from a comprehensive instrument optimization process including all Operating Rooms at Aarhus University Hospital. Adopting a holistic perspective, the optimization process, involved aligning instrument trays across various surgical specialties. This included: a) Reduction in number of instruments, b) Consolidation or separation of trays, c) Modularization - introducing modular trays for specific purposes, and d) Standardization - standardizing commonly used instruments across specialties. Instruments per tray, total number of instruments, and changes in the number of trays were compared against existing tray contents to identify discipline-specific changes.</div></div><div><h3>Results</h3><div>Some specialties made substantial alterations to tray structures, while others primarily reduced number of instruments in existing trays. Across all specialties, optimization resulted in 17 % decrease in number of tray types (<em>p</em> = 0.01, 95%CI:1.0–6.8), 1 % increase in total number of trays (<em>p</em> = 0.36, 95%CI:-11.9–4.8), 18 % decrease in number of instruments per tray (<em>p</em> = 0.0002, 95%CI: 3.2–7.6) and 16 % reduction in total number of instruments for all specialties (<em>p</em> &lt; 0.0001, 95%CI:404–758).</div></div><div><h3>Conclusion</h3><div>This study underscores complexity of instrument tray design. The approach employed at Aarhus University Hospital, involving interdisciplinary experts in an iterative design process, demonstrated the feasibility of redesigning instrument trays with significant reduction in content. Additionally, data suggests that reducing the number of instruments could lead to a decrease in workload within the Central Sterile Supply Specialty. This presents opportunity to minimize wasted resources and streamlining cleaning processes for unused instruments.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142426030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical subspecialist distribution and Social Vulnerability Indices in the inland empire","authors":"","doi":"10.1016/j.sopen.2024.09.003","DOIUrl":"10.1016/j.sopen.2024.09.003","url":null,"abstract":"<div><h3>Background</h3><div>Access to surgical specialty care differs based on geographic location, insurance status, and subspecialty type. This study uses the Inland Empire as a model to determine the relationship between Social Vulnerability Indices (SVIs), surgeon sex, and surgical subspecialty distribution.</div></div><div><h3>Methods</h3><div>823 census tracts from the Centers for Disease Control's (CDC) SVI 2018 database were compared against 992 surgeons within 30 distinct subspecialties. This data was retrieved from the American Medical Association's (AMA) 2018 Physician Masterfile. Spearman's bivariate and multiple regression were used to compare the relationship between SVI and number of surgical subspecialists within each census tract.</div></div><div><h3>Results</h3><div>There were approximately 3.34 male and 0.35 female surgeons per census tract (<em>t</em>(267) = 7.74, <em>p</em> &lt; 0.001). Significant inverse relationships existed between Cosmetic surgery, Urology and Minority status/language (ρ = −0.131 [95 % CI −1.000 to −0.028], <em>p</em> = 0.016; ρ = −0.142 [95 % CI −1.000 to −0.039], <em>p</em> = 0.010, respectively); General surgery, Socioeconomic status (ρ = −0.118 [95 % CI −1.000 to −0.014], <em>p</em> = 0.027), and Household composition/disability (ρ = −0.203 [95 % CI −1.000 to −0.102], <em>p</em> &lt; 0.001); Hand surgery and Socioeconomic status (ρ = −0.114 [95 % CI −1.000 to −0.010], <em>p</em> = 0.031); Otolaryngology, Housing type/transportation (ρ = −0.102 [95 % CI −1.000 to 0.001], <em>p</em> = 0.047), and Overall Social Vulnerability (ρ = −0.105 [95 % CI −1.000 to −0.001], <em>p</em> = 0.043). Multiple regression analyses reinforced these findings.</div></div><div><h3>Conclusions</h3><div>This study concludes that social vulnerability is predictive of, and significantly linked to, differences in distribution of surgical subspecialty and surgeon gender. Future research should investigate recruitment of a diverse surgical workforce, infrastructural barriers to care, and differences in quality of care.</div></div><div><h3>Key message</h3><div>Our work demonstrates complex relationships between surgical subspecialist distribution, surgeon gender, and a census tract's various Social Vulnerability Indices. Thus, this research can serve to continue educating surgeons and other healthcare providers about the importance of social determinants of health in the construction of healthcare policy and practice, as well as incentivizing equitable recruitment of a diverse population of surgeons.</div></div>","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2589845024001179/pdfft?md5=d02d874d0ad6d8dae3cb70e8afdd9626&pid=1-s2.0-S2589845024001179-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142310422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in developing academic surgery in a Ukrainian university clinic","authors":"","doi":"10.1016/j.sopen.2024.09.002","DOIUrl":"10.1016/j.sopen.2024.09.002","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S2589-8450(24)00126-X","DOIUrl":"10.1016/S2589-8450(24)00126-X","url":null,"abstract":"","PeriodicalId":74892,"journal":{"name":"Surgery open science","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142442196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}