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Aims & Objectives: The primary aim of this paper is to determine whether smart glasses or head-mounted displays improve efficiency in a procedural or theatre setting without compromising the quality of the procedure performed. Additionally, this paper aims to qualitatively explore applications in surgical education, whilst on-call, consulting and patient observation. Design: This paper is a systematic review of the literature available on the topic of smart glasses or head-mounted displays in surgical or procedural settings. Methods: A search of Pubmed, Cochrane and the Wiley Online Library was performed in accordance with the PRISMA guidelines. Procedural times and adverse outcomes were compared between the smart glass and non-smart glass groups in each of the quantitative studies. A literature review of studies, including those not satisfying the primary aim was conducted and is included in this paper. Results: 32 studies were identified that complied with the inclusion criteria of this paper. 8 of these studies focused on procedural times and adverse outcomes, with and without smart glass usage. Procedural time was reduced when smart glass technology was used, without an increase in adverse patient outcomes. Conclusions: Surgeons should consider whether the relatively short reduction in procedural time is worth the high cost, privacy issues, battery complaints and user discomfort involved with these devices. There are promising applications of this technology in the areas of surgical education and consultation. However, more trials are necessary to assess the value of using smart glasses in these settings. [ABSTRACT FROM AUTHOR]

Traditionally, esophageal oncological resections have been performed via open approaches with well-documented levels of morbidity and mortality complicating the postoperative course. In contemporary terms, minimally invasive approaches have garnered sustained support in all areas of surgery, and there has been an exponential adaptation of this technology in upper GI surgery with the advent of laparoscopic and robotic techniques. The current literature, while growing, is inconsistent in reporting on the benefits of minimally invasive esophagectomies (MIEs) and this makes it difficult to ascertain best practice. The objective of this review was to critically appraise the current evidence addressing the safety, efficacy, and cost-effectiveness of MIEs versus open esophagectomies. A systematic review of the literature was performed by searching nine electronic databases to identify any systematic reviews published on this topic and recommended Joanna Briggs Institute approach to critical appraisal, study selection, data extraction and data synthesis was used to report the findings. A total of 13 systematic reviews of moderate to good quality encompassing 143 primary trials and 36,763 patients were included in the final synthesis. Eleven reviews examined safety parameters and found a generalized benefit of MIE. Efficacy was evaluated by eight systematic reviews and found each method to be equivalent. There were limited data to judiciously appraise cost-effectiveness as this was only evaluated in one review involving a single trial. There is improved safety and equivalent efficacy associated with MIE when compared with open esophagectomy. Cost-effectiveness of MIE cannot be sufficiently supported at this point in time. Further studies, especially those focused on cost-effectiveness are needed to strengthen the existing evidence to inform policy makers on feasibility of increased assimilation of this technology into clinical practice. [ABSTRACT FROM AUTHOR]

Background: Cricket is a sport in which hand injuries occur commonly, and yet the only players allowed to wear protective gloves are the batsman and wicketkeeper. This study aims to analyse the pattern of hand injuries occurring at the amateur level of the game. Methods: A prospective analysis was performed of all cricket hand injuries presenting to a specialist plastic surgery unit over the course of 3 months. Data was collected on the types, mechanisms and sites of injury, as well as their distribution amongst different playing positions. Results: There were a total of 28 injuries, the majority of which were sustained whilst fielding ( n = 22), with only five injuries occurring in batsmen or wicketkeepers. Twenty-three injuries were sustained by way of a direct blow or axial load to the fingers, with the ulnar digits and thumb most commonly affected. There were 20 fractures and eight dislocations, and 25 were associated with soft tissue injury. The distal phalanx was the most frequently injured site ( n = 11), followed by the distal interphalangeal (DIP) joint. Most of the injuries were suitable for conservative management with only three patients requiring bony fixation. Only 15 of the 27 players stopped playing at the time of their injury, with significant delay to presentation to our unit in ten cases. Conclusions: Our survey highlights that hand injuries are common amongst amateur cricket players, and that a lack of protective gloves, improper catching technique and delay in seeking treatment may be important factors. Level of Evidence: Level IV, diagnostic study. [ABSTRACT FROM AUTHOR]

Subintimal angioplasty is a safe, effective, but nondurable procedure in treating long superficial femoral artery occlusions in patients with severe tower limb ischemia. The authors report a case of acute thrombosis that presented 16 weeks after subintimal angioplasty. The "Trellis" percutaneous thrombolytic infusion system permitted a controlled site-specific infusion of recombinant tissue-type plasminogen activator (rtPA). The unique design of the "Trellis" allowed complete aspiration of thrombus and avoiding regional and systemic thrombolytic side effects. The "Trellis" system is effective in percutaneous management of thrombotic lesions; however, intimal dissection may need to be addressed. [ABSTRACT FROM AUTHOR]

Complications after open aortic surgery pose a challenge both to the vascular surgeon and the patient because of aging population, widespread use of cardiac revascularization, and improved survival after aortic surgery. The perioperative mortality rate for redo elective aortic surgery ranges from 5% to 29% and increases to 70–100% in emergency situation. Endovascular treatment of the postaortic open surgery (PAOS) patient has fewer complications and a lower mortality rate in comparison with redo open surgical repair. Two cases of ruptured abdominal aortic aneurysm CAM) were managed with the conventional open surgical repair. Subsequently, spiral contrast computer tomography scans showed reperfusion of the AAA sac remnant mimicking a type III endoleak. These graft-related complications presented as vascular emergencies, and in both cases endovascular aneurysm repair (EVAR) procedure was performed successfully by aortouniiliac CAUI) stent graft and femorofemoral crossover bypass. These 2 patients add further merit to the cases reported in the English literature. This highlights the crucial importance of endovascular grafts in the management of such complex vascular problems. [ABSTRACT FROM AUTHOR]