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Objective: The present study aimed to determine the difference in force required to puncture simulated pleura comparing Kelly clamps to fine artery forceps. The treatment of symptomatic traumatic pneumothorax and haemothorax involves puncture of the parietal pleura to allow decompression. This is usually performed using Kelly clamps or fine artery forceps. Over‐puncture pulmonary injury risk increases with the force used. Methods: An experienced single operator performed puncturing of simulated parietal pleura on a thoracic mannequin while wearing a force sensor under gloves. The force imparted at the device tip onto the parietal pleura was estimated by subtracting the force required to hold the device from the total force. Outcome variables were the total maximum force and force imparted by the device. Results: There were 11 simulated procedures completed, seven using Kelly clamps and four using fine artery forceps. After subtracting the force required to hold the chosen forceps, the median value of pleural puncture force using Kelly clamps was 52.91 N (IQR 36.68–63.56) and 10.70 N (IQR 7.64–26.56) using fine artery forceps (P = 0.006). Conclusion: A significantly increased force was required to puncture simulated parietal pleura using Kelly clamps compared to fine artery forceps. This higher puncture force will be associated with increased instrument acceleration at the time of pleural puncture, which may result in an increased risk of injury to the underlying lung. Based on these data, clinicians may reduce the risk of pulmonary injury by using fine artery forceps rather than Kelly clamps when performing pleural decompression. [ABSTRACT FROM AUTHOR]

Research Summary: Venture capital funds have a limited lifecycle. As the fund ages, venture capitalists (VCs) are motivated to promote venture exit discussions with the venture board. We investigate the impact of VCs' exit pressure on the hazard of four types of venture exit (IPO, high‐value M&A, low‐value M&A, and liquidation), considering how VCs' exit pressure influences board collaboration. We find that while the VCs' exit pressure does not affect the hazard of IPOs, the pressure significantly increases the hazard of M&A and liquidation. Achieving important milestones does not reduce the impact of exit pressure on the hazard of low‐value M&A and liquidation. Independent directors moderate the impact of the VC's exit pressure, increasing the hazard of high‐value M&A and lessening the hazard of liquidation. Managerial Summary: We investigate whether VCs' exit pressure due to an approaching deadline for fund liquidation influences the time to venture exit and how board composition affects the relationship between VCs' exit pressure and venture exit. Data from a sample of 219 VC‐backed U.S. surgical device ventures founded during 1989–2014 suggest that VCs' exit pressure decreases the time to M&A (both high‐value and low‐value M&A) and liquidation. Boards with more independent directors facilitate high‐value M&A and delay liquidation. VCs' exit pressure does not affect the time to IPO. These results provide evidence of the impact of the venture capital fund's finite life on investees other than the VCs and confirm the crucial role of independent directors in managing VCs' exit pressure. Video Abstract [ABSTRACT FROM AUTHOR]

Purpose: Small-bites suturing technique for laparotomy closure is now recommended as the standard of care. However, uptake of the practice remains slow. A medical technology called the SutureTOOL has been developed which can facilitate implementation of small-bites. The aim of the study was to compare the economic and clinical outcomes of laparotomy closure for patients using manual needle-driver suturing versus device-assisted suturing (SutureTOOL) following open abdominal surgery., Methods: This cost-effectiveness analysis comparing device-assisted suturing to needle-driver suturing was performed from a healthcare perspective within Sweden, France, the UK, and the US. A decision tree model was developed to implement the analysis., Results: The SutureTOOL was found to be cost-effective, reducing costs between 22% and 40% across country contexts. Savings were associated with reduced post-operative complications and reductions in operating room time. Improvements in quality of life were minimal and not clinically significant, likely because of the short time horizon., Conclusion: Cost-effectiveness was largely due to cost savings. Prior to procurement, hospitals should test the device to ensure that small-bite rates and reductions in operation time are replicable within their clinical context. If so, the device will improve quality of care for laparotomy wound closure., Competing Interests: Declarations. Conflict of interest: Gabriel Börner is the founder and Chief Medical Officer of Suturion AB, and Sophia Verheij-Engqvist is an employee at Suturion AB. Smile Incubator, an incubator in Sweden, provided funding to Suturion AB to finance this health economic study. Suturion AB used the Smile funds to contract The Swedish Institute for Health Economics to lead the health economic study. Zin Min Thet Lwin is employed as a research analyst, and George Keel as a research manager, at the Swedish Institute of Health Economics., (© 2025. The Author(s).)

Staphylococcus aureus is one of the prominent causes of hospital-acquired bacteremia. Despite the availability of anti-staphylococcal antibiotics, hospital acquired S. aureus bacteremia is still a major problem with considerable morbidity and mortality. Therefore, the aim of this study was to isolate, identify and determine the Antibiotics susceptibility profile of Staphylococcus aureus from the surfaces of surgical equipment and environment of major public and private hospitals in Lokoja, Kogi State, Nigeria using colonial characteristics, microscopy and conventional biochemical techniques. The Antibiotics susceptibility profile of the isolates was determined in accordance with the Guidelines of Clinical and Laboratory Standard Institute (CLSI). A total of three hundred and fifty (350) swab samples comprising of fourty (40) from surgical equipment and three hundred and ten (310) from the environment were collected from three (3) different public and private hospitals within Lokoja metropolis. The results obtained showed that 110(31.4%) of samples from the hospital environment were confirmed positive for Staphylococcus aureus with Hospital A constituting 30(8.6%), Hospital B had 59(16.8%) and Hospital C recorded 21 (6.0%). Of the 19 selected S. aureus isolates for antimicrobial susceptibility screening, 10.52% and 5.26% were intermediately resistant to Norfloxacin and Chloramphenicol respectively. Furthermore, the screened S. aureus isolates showed 100% susceptible to Ciprofloxacin, Gentamicin and Erythromycin; 94.73% susceptible to Chloramphenicol and 89.47% susceptible to Levoflaxin. The result also revealed 100% resistance to Penicillin and 15.78% resistance to Rifampicin. The high presence of Staphylococcus aureus in the hospital environment is a potential threat to the health of the patients and the public as this organism has been implicated in several human diseases, especially hospital- acquired bacteremia. Therefore, improved personal and public hygienic practices within the hospitals are required to reduce the high presence of S. aureus and other pathogenic microorganisms.

This letter commends the research conducted by Çanakcı et al. on the relationship between patient positioning during Retrograde Intrarenal Surgery (RIRS) and the stone-free rate after surgery for kidney stones smaller than 2 cm. The study compared the traditional stone-cutting position with the improved Trend-side position and found that the Trend-side position improved the stone-free rate and reduced fragmentation time without increasing complications. However, the study's single-center nature and small sample size may limit the generalizability of the results, and future studies should explore the potential benefits of the Trend-side position in different patient groups and surgical settings. Other factors, such as stone composition and patient lifestyle, should also be considered in future studies. Additionally, a cost-benefit analysis and longer-term follow-up would provide a more comprehensive understanding of the benefits of the Trend-side position. The study's use of low-dose non-contrast CT to assess stone clearance status is a strength, but other detection methods could be considered for a more thorough investigation of the results. Overall, the authors' contributions are appreciated, and future research is eagerly anticipated. [Extracted from the article]

This study explored the ideal period for wearing masks to prevent the physiological and psychological problems associated with long-term face mask use during respiratory infections by healthcare workers. Breathing simulators, surgical masks (SM) and medical respirators (PM) were prepared for two to eight hours. Changes in the comfort of masks (facial skin temperature, breathing resistance, and moisture permeability) and protection (filtration efficiency, resistance to blood penetration, and colony count) were assessed. The results demonstrated that the masks offered efficient liquid-particle filtering even after eight hours of use. However, the number of bacterial colonies using PM and SM grew significantly after two and four hours, respectively. Concerning comfort, the inspiratory resistance of masks rose dramatically after two hours, whereas the moisture permeability declined considerably after four hours. In addition, skin temperature had a significant increase within two hours, which may result in facial discomfort. When conditions permitted, the hospital staff was instructed to replace their masks every two hours. [ABSTRACT FROM AUTHOR]

Mastery of microsurgical technique requires thousands of hours of deliberate practice, often with equipment that is not accessible to medical students. This study aimed to develop, test, and report a novel simulation system for providing medical students with early access to microsurgical technique. Low-cost, user-friendly, reusable microsurgery kits were iteratively developed using excess surgical supplies, such as catheter tubing and vessel loops. Students were tested on 2 separate tasks, with grading via a standardized performance scale incorporating aspects of alignment, leak, and anastomotic patency. Twelve medical students were tested on standardized microsurgery kits at 2 different time points 6 weeks apart with no additional training received in between. Median change in total score on the vessel loop suturing task after 6 weeks was +2.6 points (range, −1.7 to +5 points); median change in completion time was −1.9 minutes (range, −3.5 to +2.7 minutes). Median change in total score on the red rubber anastomosis task was +5.8 points (range, −2.6 to +9.6 points) with a median improvement of −4.3 minutes (range, −9.6 to +2.6 minutes). Reusable microsurgery kits designed with excess surgical supplies are educationally impactful tools that introduce medical students to microsurgical techniques early in their training, while also providing objective measures for skills acquisition over time. [ABSTRACT FROM AUTHOR]

As part of efforts to combat the Covid-19 pandemic and decrease the high transmissibility of the new coronavirus, SARS-CoV-2, effective inactivation strategies, such as UV-C decontamination technologies, can be reliably disseminated and well-studied. The present study investigated the susceptibility of a high viral load of SARS-CoV-2 in filtering facepiece respirators (FFR) N95, surgical mask, cotton fabric mask and N95 straps under three different doses of UV-C, applying both real-time PCR (qPCR) and plaque formation assays to quantify viral load reduction and virus infectivity, respectively. The results show that more than 95% of the amount of SARS-CoV-2 RNA could be reduced after 10 min of UV-C exposure (0.93 J cm−2 per side) in FFR N95 and surgical masks and, after 5 min of UV-C treatment (0.46 J cm−2 per side) in fabric masks. Furthermore, the analysis of viable coronaviruses after these different UV-C treatments demonstrated that the lowest applied dose is sufficient to decontaminate all masks (∼ 3-log10 reduction of the infective viral load, > 99.9% reduction). However, for the elastic strap of N95 respirators, a UV-C dose three times greater than that used in masks (1.4 J cm−2 per side) is required. The findings suggest that the complete decontamination of masks can be performed effectively and safely in well-planned protocols for pandemic crises or as strategies to reduce the high consumption and safe disposal of these materials in the environment. [ABSTRACT FROM AUTHOR]

Background: The nature of COVID-19 transmission creates significant risks in surgical departments owing to the close contact of medical staff with patients, the limited physical environment of the operating room and recovery room, the possibility of shared surgical equipment and challenges in the delivery of surgical care in all surgical departments. Globally, studies have reported that the effects of the pandemic on surgical departments are profound, potentially long-lasting and extensive. To manage these effects, different local guidelines and recommendations have been developed, with potential differences in their effectiveness and implementation. Therefore, harmonized and effective national/international guidelines for specific surgical departments during perioperative periods are pertinent to curtail the infection, and will inevitably need to be adapted for consistent and sustainable implementation by all medical staff. The pattern of surgical patient care during the COVID-19 pandemic at Jimma Medical Center (JMC), Ethiopia, has not been explored yet. The present study aimed to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC. Methods: A cross-sectional study was conducted to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC, using five-point Likert scales (0, not at all; 1, rarely; 2, sometimes; 3, most of the time; 4, frequently). A total of 90 respondents [35 patients (five patients from each of seven surgical departments) and 55 healthcare providers (six professionals from each of nine units, including the center of sterility room and anesthesia)] who were available during the study period, selected by a convenience sampling technique with multistage clustering, participated in the study. Data were collected using a structured questionnaire via direct observation and face-to-face interviews with patients undergoing surgery, healthcare providers and hospital administrators, against the standard surgical patient care guidelines. The collected data were manually checked for missing values and outliers, cleared, entered into EpiData (v4.3.1) and exported to SPSS (v22) for analysis. The mean score of practice was compared among different disciplines by applying the unpaired t-test. The findings of the study were reported using tables and narration. A p-value of less than 0.05 was declared as statistically significant. Results: Despite the surgical care practice having changed during the COVID-19 pandemic in all service domains, it is not implemented consistently among different surgical departments owing to different barriers (lack of training on the updated guidelines and financial constraints). The majority of surgical staff were implementing the use of preventive measures against COVID-19, while they were practiced less among patients. The guidelines for surgical practice during the preoperative phase were well applied, especially screening patients by different methods and the application of telemedicine to reduce physical contacts. But, against guidelines, elective patients were planned and underwent surgery, especially in the general surgery department. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. The extent of practice for anesthesia care, operating room management and postoperative care in the recovery room also changed, and the guidelines were sometimes applied. Conclusion and Recommendations: Although perioperative surgical care practice differed before and during the pandemic, the standard guidelines were inconsistently implemented among surgical departments. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. Thus, the authors developed safe surgical care guidelines throughout the different domains (infection prevention and PPE use; preoperative care, intraoperative care, operating room management, anesthesia care, equipment handling process and postoperative care) for all disciplines and shared them with all staff. We recommend that all surgical staff should access these guidelines and strictly adhere to them for surgical service during the pandemic. [ABSTRACT FROM AUTHOR]

Pressure ulcers are soft‐tissue damage associated with tissue exposure to sustained deformations and stress concentrations. In patients who are proned for ventilation or surgery, such damage may occur in the superficial chest tissues that are compressed between the rib cage and the support surface. Prophylactic dressings have been previously proven as generally effective for pressure ulcer prevention. In this study, our goal was to develop a novel computational modelling framework to investigate the biomechanical efficacy of a dressing with a soft cellulose fluff core in protecting proned surgical patients from chest pressure ulcers occurring on the operating table, due to body fixation by the Relton‐Hall frame. We compared the levels of mechanical compressive stresses developing in the soft chest tissues, above the sternum and ribs, due to the trunk weight, whilst the body is supported by the Relton‐Hall frame pads, with versus without the prophylactically applied bilateral dressings. The protective efficacy index for the extremely high stresses, above the 95th‐percentile, were 40.5%, 25.6% and 24.2% for skin, adipose and muscle, respectively, indicating that the dressings dispersed elevated soft‐tissue stresses. The current results provide additional support for using soft cellulose fluff core dressings for pressure ulcer prophylaxis, including during surgery. [ABSTRACT FROM AUTHOR]

Simple Summary: Depending on the location and configuration of renal tumors, it is sometimes difficult to grasp, excise, and properly remove them. We have designed and developed a device to improve robotic laparoscopic partial nephrectomy. We tested the device on porcine kidneys and livers and embalmed human cadavers. A preliminary evaluation of this surgical tool showed satisfactory device setup, suction, and tissue handling characteristics. In this paper, we describe the development and evaluation of a novel tissue-holding device (THD) for use during robotic-assisted laparoscopic partial nephrectomy. The THD is a vacuum-based apparatus made of either 3D-printed polyethylene or stainless steel. The proximal end connects to suction tubing routed outside the body, while the distal end is conically shaped and designed to firmly interface with the tumor. Device feasibility studies were performed on six porcine kidneys, two porcine livers, and two embalmed human cadavers. A Likert-scale rating was used to assess device setup, suction, and tissue handling. Additional tests were performed using the daVinci Xi® robotic system. Finally, the holding force of the THD was assessed using different standard vacuum systems and pressure settings. In porcine tissue, the device setup, tissue suction, and handling were rated as "good". THD insertion and removal was uncomplicated. In a simulated transabdominal approach on fixed human cadavers, the device setup, suction, and tissue handling were also rated as "good". No macroscopic tissue compromise or device deterioration was noted. The handling and holding abilities using the daVinci Xi® robotic system were also rated "good". The device was able to successfully hold over 300 g of tissue at a suction pressure of −600 mmHg. The preliminary evaluation of the THD demonstrated satisfactory results. [ABSTRACT FROM AUTHOR]

Introduction: To assess the practical knowledge, interest, and training levels of surgeons enrolled in the Brazilian College of Surgeons (CBC) of the municipality of Porto Alegre, Rio Grande do Sul, regarding robotic surgery. Methods: Cross-sectional study, based on information collected with a questionnaire sent to potential participants via digital platform. The form contained structured and self-administered questions, to characterize their professional profile, skills in minimally invasive surgery, knowledge, opinion, and specific training in robotic surgery. Results: Of the 146 members enrolled in the CBC of the municipality of Porto Alegre, 99 (67.8%) responded to the questionnaire. Most were males (88%) with a mean age of 48 years. Video-laparoscopic or video-assisted procedures were the most frequent in the participants' practice. Of the sample, most (78%) already watched at least one robotic surgery, and one third (n = 30) had already completed some sort of training or simulation course in robotic surgery. Among those who did not, two thirds intend to pursue formal training in the future. Only 10% of participating surgeons are certified in the area. Conclusion: Most responding surgeons enrolled in the CBC in Porto Alegre perform mostly minimally invasive procedures daily and believe that the robotic technology will be the future of surgery. Although not yet available in most services of the state of Rio Grande do Sul, it is expected that the development of new platforms and the reduction of costs involved in equipment acquisition and surgical training will facilitate the dissemination of this technology. [ABSTRACT FROM AUTHOR]

Background: Industrial revolutions play a major role in the development of technologies in various fields. Currently, the world is marching towards softwarization and digitalization. There is an emerging need for conversion of Industry 4.0 to Industry 5.0 for technological development and implementation of the same in the digital era. In health care, digitalization emerged in Industry 4.0 revolution. To enhance patient care and quality of life, Industry 5.0 plays a major role in providing patient-centric care and customization and personalization of products. The integration of human intelligence with artificial intelligence provides a precise diagnosis and enhances the recovery and functional outcome of the patients. Materials and methods: In this manuscript, the domains and limitations of Industry 5.0 and further research on Industry 6.0 were elaborated on to bring out technologies in better health care. Results: Industry 5.0 lessens the work of medical professionals and integrates software-based diagnosis and management. It provides cost-effective manufacturing solutions with limited resources compared to Industry 4.0. Industry 5.0 focuses on SMART and additive manufacturing of implants, and the development of bio-scaffolds, prosthetics, and instruments. In this manuscript, the domains and limitations of Industry 5.0 and further research on Industry 6.0 were elaborated on to bring out technologies in better health care. Conclusion: 'The personalization and customization of products' are the hallmarks of this evolving Industry 5.0 revolution. The major uplifts in various domains of industry 5.0 such as advanced automation, digitalization, collaborative robots, and personalization bring this an inevitable mechano-scientific technological revolution in this current medical era. [ABSTRACT FROM AUTHOR]

Background: Although there is no consensus regarding the best skin disinfection technique, whatever antiseptic solution is used, the "prep and drape" portion of most upper extremity procedures requires the presence of at least one operative room assistant or scrub nurse to elevate and hold the hand and forearm. Nonetheless, especially in a busy hand surgery practice and during fast procedures, an operative room assistant or scrub nurse are frequently not available leading to a reduced time efficiency between procedures. Purpose: This article describes an innovative easy-to-use and hands-free device that helps the surgeon during disinfection of the skin and the setup of the surgical field by keeping elevated the upper limb with respect for tissues. Methods: The development of the surgical arm holder starts from three easily available and washable thermoplastic splint sheets 40 × 60 cm with 2.5 cm thickness. The final device measures 40 × 25 × 15 cm and is placed underneath the proximal third of the humerus in order to keep the upper limb suspended at about 10–15 cm from the operating table. A retrospective analysis of the "surgical malpractice claims" and institutional non-conformities registered in the period 2011–2020 was conducted in our Hospital looking for bone or soft tissue complications related to the use of the device. Results: Three thousand one hundred eighty-seven surgical procedures were performed between 2011 and 2020 using this device. The retrospective analysis of all "surgical malpractice claims" showed no skin lesions, no neurological complications (such as neuroapraxia), no need for secondary bone procedures or interference with the draping process. Conclusion: Our device proved to be a low-cost, easy to use and alternative solution helping surgeons during the disinfection phase, improving hospital pre-operative flow and reducing the need for other staff members to be engaged in holding the upper limb in the operating room. [ABSTRACT FROM AUTHOR]

Breast reconstruction incidence increased, including preventive surgery. In this context, providing women best surgical care and results is crucial, with minimum complications, such as wound dehiscence and skin flap necrosis. Tension‐free closure of skin flaps is mandatory for successful healing. However, since this is not always possible, various techniques have been developed to reduce tension from wound margins, facilitate primary wound closure, and minimize and improve scarring. These techniques have not been investigated in breast surgeries. The aim of this study was to describe our experience with the Tension‐Relief System in mastectomy and breast reconstructive patients, and the advantages of using this technique. The retrospective cohort consisted of 13 breasts of 11 women aged 29–74 years who underwent surgery with primary wound closure using the System, in 2019–2020 in our department. It was applied averagely 19.7 days, demonstrated effectiveness in preventing complications and as secondary treatment following complications. This enabled avoiding further and more extensive surgeries, including donor‐site morbidity when needed. In mastectomy and breast reconstruction, the system minimizes complications and yields satisfactory esthetic and functional outcomes, with minimal inconvenience to the patient, and good pain control. The technique is low‐cost, simple to use, and does not require special settings, surgical equipment, or particular skills. [ABSTRACT FROM AUTHOR]

Background: The aim of international health cooperation projects is to alleviate the deficiencies in the area of health in low resource settings. Hernia surgery is a procedure that is well suited to these missions, due to its low morbidity, the fact that it can be performed on an outpatient basis, and the improvement in quality of life that it provides.Objective: To describe the results of Benefica Chirurgia (BC), a Spanish non-profit humanitarian association in hernia pathology.Methods: Five one-week surgical campaigns were carried out in Ecuador between 2015 and 2019, involving anesthetists, general and pediatric surgeons. Surgical and medical equipment was provided and transported by BC. ASA I/II patients underwent surgery.Results: Surgery was performed on 240 patients with hernia pathology on 27 days. Sixty-three per cent of patients were male and the mean age was 48.2 years (range: 1-83). Hernia location was inguinal in 113 patients, umbilical in 101, and other in 26. The anesthetic technique used was spinal in 185 patients (77.1%), local plus intravenous sedation in 31 (12.9%), and general in 24 (10%). The surgical technique used was hernioplasty in 191 patients, herniorrhaphy in 31, incisional hernia repair in 15 and herniotomy in three. Surgery was performed on an outpatient basis in 98.4% of cases. Morbidity was 2%. Long-term postoperative evaluation is very complex.Conclusion: These campaigns make a significant contribution to health in low resource settings and provide great personal satisfaction for those involved. Standards achieved in the immediate postoperative period were similar to those obtained at the surgeons' centers in Europe. However, it is difficult to establish the rates of recurrence and chronic pain. [ABSTRACT FROM AUTHOR]

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Background/Aim: Laparoscopic sleeve gastrectomy has been accepted in obesity surgery, as it provides rapid weight loss and has low mortality rates. However, because of the long staple line, leakage is a significant problem for these patients. Buttressing methods can be used to reduce the leakage. The aim of this study was to evaluate the efficacy of clips for buttressing the staple line on resected sleeve gastrectomy patients. Methods: The study included 20 patients aged 18–60 years who underwent laparoscopic sleeve gastrectomy surgery in our clinic. Any patients with connective tissue disease or with the removed stomach tissue not intact were excluded from the study. The age, gender, height, weight, and additional disease data were recorded. A manual manometer and inflation mechanism was created, and when the pressure suddenly dropped and a bubble was observed from the staple line, this value was recorded as the leakage pressure. By measuring the leakage pressure in the staple line by inflating the resected and removed stomach, leakage pressure and leakage location were recorded as no-clip leakage pressure. Then, the observed area of leakage was buttressed with laparoscopic clips, and the leakage pressure was measured once more by inflating the stomach; this value was recorded as the clipped leakage pressure. Results: The first pressure value observed had a mean of 43.8mmHg (range, 35–55 mmHg); after application of the clips, the mean was 43.8 mmHg (range (40–50 mmHg) (P = 0.20). The leakage was located in the upper section in 14 (70%) cases, in the mid-section in 5 (25%) cases, and in the lower section in 1 (5%) case. Micro-leakage was observed in 15 (75%) cases, 1-mm leakage in 1 (5%) case, 2- mm leakage in 2 (10%) cases, and 3-mm leakage in 2 (10%) cases. Conclusion: Leakage is the most significant complication following sleeve gastrectomy surgery. The use of laparoscopic clips was described as a buttressing method, but no positive effect of metal clips on leakage pressure was observed in our study. Clarification of the effect of the buttressing with metallic clips is required using in vivo and ex vivo experiments. [ABSTRACT FROM AUTHOR]

Using computed tomography scans, we were able to treat symptomatic osteoid osteoma of the distal radius with the help of 3D printing technology that involves designing bone models and fabricating surgical guides to locate the tumour precisely and resect it successfully with limited exposure without the use of any intraoperative imaging. This is a new technology that can be applied to treat bony lesions and can be an alternative solution to currently available techniques. [ABSTRACT FROM AUTHOR]

BACKGROUND: Da Vinci surgery is used extensively, but the high costs of the surgical instrument are a serious clinical and management problem. OBJECTIVE: To reduce the cost of the Da Vinci robotic surgical instrument supply chain. METHODS: Patients were selected from the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China. Control group patients underwent Da Vinci robot-assisted surgery between January 2019 and June 2019 (control group). Patients who were operated with the same robot from July 2019 to December 2019 were selected as the experimental group (SCM group). The cost analysis and comparison were carried out to integrate instrument sets, working hours, workforce expenditure, and direct and indirect expenses. RESULTS: Compared with the control group, the number of instrument packages was lower (4.5 ± 1.4 vs. 11.5 ± 1.6, P < 0.001) and the personnel's awareness of the instruments was higher (92.3 ± 4.2 vs. 83.4 ± 3.7, P < 0.001) in the SCM group. The SCM group showed lower processing time per device (8.1 ± 1.6 vs. 44.2 ± 5.6 min, P < 0.001) and lower costs per surgical instrument (RMB 11.5 ± 2.3 vs. 60.3 ± 10.2, P < 0.001). CONCLUSION: The application of the supply chain management can reduce the costs of robotic surgery, improve work efficiency and decrease the failure rate of instruments. [ABSTRACT FROM AUTHOR]

Background  Lymphaticovenular anastomosis (LVA) is an effective, functional treatment for limb lymphedema. This study reports an alternative surgical approach to lymphedema treatment without the use of indocyanine green mapping. Methods  A retrospective analysis was performed on 29 consecutive lymphedema patients who underwent LVAs from January 2015 to December 2020, whereby incisions were made along the anatomy of the superficial venous systems in both upper and lower extremities around the joint areas. The evaluation included qualitative assessments and quantitative volumetric analyses. Result  The mean number of anastomoses was 3.07, and the operative time was 159.55 minutes. Symptom improvement was recorded in 86.21% of the patients, with a mean volume reduction of 32.39%. The lymphangitis episodes decreased from 55.17% before surgery to 13.79% after surgery, and the median number of lymphangitis episodes per year decreased from 1 before surgery to 0 after surgery. Conclusions  The superficial venous anatomical approach is an easy way to start a lymphedema practice using LVA without other advanced surgical equipment. With this reliable technique, microsurgeons can perform LVA procedures and achieve good results. [ABSTRACT FROM AUTHOR]

The power characteristics and safety of a system for wireless inductive power transfer to operating room medical equipment were studied. The design parameters for systems able to transmit loads of 1 and 2 kW were determined. The action of the electromagnetic fields arising on operation of systems on humans was studied. This work shows that power transfer systems for supplying operation room equipment which are safe for humans can be developed. [ABSTRACT FROM AUTHOR]

Upper tract urothelial carcinoma (UTUC) is a relatively rare cancer, and much of the approach to treatment has been derived from strategies employed in treating bladder cancer. Radical nephroureterectomy (RNU) is regarded as the gold standard treatment for UTUC. However, due to potential complications, such as renal function impairment, that can affect oncologic outcomes, the demand for nephron-sparing treatment to effectively treat cancer while preserving renal function has increased. As a result, various treatment methods for low-grade, low-volume UTUC, such as segmental ureterectomy, endoscopic resection, and intraluminal therapy, have been attempted and reported. Although these treatment modalities have exhibited acceptable oncological results, further studies are required. In the future, the introduction of new technologies, such as improved diagnostic and surgical equipment, and new drug delivery systems, could enhance the effectiveness of nephron-sparing strategies in the treatment of UTUC. Additionally, understanding the biological and genetic characteristics of UTUC that distinguish it from those of bladder cancer will also aid in establishing strategies for nephron-sparing. [ABSTRACT FROM AUTHOR]

Objectives: The use of current robotic systems to assist in percutaneous coronary intervention (PCI) fundamentally differs from performing conventional PCI. To overcome this problem, we developed a novel master-slave robotic control system to assist in PCI, and evaluated its safety and feasibility in the delivery and manipulation of coronary guidewires in vitro and in vivo. Methods: The novel robotic assist PCI system is composed of three parts: 1) a master actuator, which imitates the traditional torque used by surgeons in conventional PCI, 2) a slave actuator, including a guidewire delivery system and force monitoring equipment, and 3) a local area network based communication system. Results: The experiment was performed in six pigs. Both robotic and manual control completed the operation with no device- or procedure-associated complications. An experienced interventional cardiologist who was a first-time user of the novel robotic PCI system was able to advance the guidewire into a distal branch of a coronary artery within a similar time to that required with the manual procedure. Conclusion: This early in vivo experiment with the novel robotic assisted PCI control system demonstrated that its feasibility, safety, and procedural effectiveness are comparable to those of manual operation. The novel robotic-assisted PCI control system required significantly less time to learn than other currently available systems. [ABSTRACT FROM AUTHOR]

Featured Application: The paper shows the procedure for producing a customized low-cost "Mask Fitter" made with a tablet-based 3D-face-scan and 3D-printing that could improve the sealing of FFP2 respirators. COVID-19 has deeply impacted clinical strategies in dentistry and the use of surgical masks and respirators has become critical. They should adapt to the person's facial anatomy, but this is not always easy to achieve. Bellus3D Company proposed to apply their face scan software, used with selected smartphones and tablets, to design and 3D-print a bespoke "Mask Fitter" to improve the sealing of surgical masks and respirators. Twenty dental staff participants were face scanned and a Mask Fitter for FFP2 respirators was designed and 3D-printed. Participants were asked to wear their Mask Fitter over one week and then completed a survey. Questions were asked about wearing comfort, sealing confidence, glasses or loupes fogging, both with and without the Mask Fitter. Dental staff gave positive feedback, with levels of comfort during daily use reported as similar with and without the Mask Fitter; and a higher confidence in achieving a proper seal, ranging from a 10% confidence rating of a proper seal without the Mask Fitter to 75% with the Mask Fitter. Moreover, fogging problems decreased considerably. The tested Mask Fitter device could represent an easy and low-cost procedure to improve the facial adaptation of the FFP2 respirator. [ABSTRACT FROM AUTHOR]