Evaluation and application of CO2 laser fiber delivery for single port transoral robotic surgery

Background

Transoral robotic surgery (TORS) using the Single-Port system (SPS) relies on electrocautery, limiting its applications in the upper aerodigestive tract. We evaluated the feasibility of a CO₂ delivery system for the SPS.

Methods

Otolaryngology residents performed a cutting exercise using a handheld CO₂ laser and participated in a cadaveric oropharyngeal dissection using the SPS with monopolar cautery (SP + EC) and CO₂ laser (SP + CO₂). Residents completed the System Usability Scale (SUS) questionnaire to evaluate these techniques.

Results

The same laser fiber was used for all combined dissections. The handheld CO₂ laser, SP + EC, and SP + CO₂ demonstrated similar SUS scores. On individual domain scores, SP + CO₂ received less favorable ratings compared to the handheld CO₂ laser for complexity, integration, and cumbersome experience (p < 0.05). On subgroup stratification, less TORS experience was associated with worse SUS scores.

Conclusion

SP-guided CO₂ laser delivery is a viable alternative to electrocautery in robotic surgery, and should be considered when performing TORS.     

Adult thoracolumbar or lumbar scoliosis with Chiari malformation and syringomyelia: a retrospective study of correction and fusion strategies

Study design  

Retrospective case series.     

Surgery of the alimentary tract for benign and malignant disease with the novel robotic platform HUGOTM RAS. A first world report of safety and feasibility

Introduction

As robotic surgery increases its reach, novel platforms are being released. We present the first 17 consecutive cases of alimentary tract surgery performed with the Hugo^TM RAS (Medtronic).

Methods

patients were selected to undergo surgery from February through April 2023. Exclusion criteria were age <16 years, BMI>60, ASA IV.

Results

17 patients underwent ileocaecal resection for Chrons disease (2 M and 1 F) and pseudo-obstruction of the terminal ileum (1 M), cholecystectomy (3 M and 5 F), subtotal gastrectomy with D2 lymphadenectomy (1 F), sleeve gastrectomy (1 F), hiatal hernia repair with Nissen fundoplication (1 M), right hemicolectomy (1 M) and sigmoidectomy (1 M). No conversion to an open approach or any arm collisions requiring corrective actions were reported.

Conclusions

Our preliminary experience with the Hugo^TM RAS point to safety and feasibility for a rather wide spectrum of surgical procedures of the alimentary tract.     

Early Effects of Gastric Banding (LGB) and of Biliopancreatic Diversion (BPD) on Insulin Sensitivity and on Glucose and Insulin Response after OGTT

Background  

Bariatric surgery improves glucose metabolism.     

Short-Term and Long-Term Outcomes After Simultaneous Resection of Colorectal Malignancies and Synchronous Liver Metastases

Background  

We evaluated the simultaneous resection of colorectal malignancies and synchronous liver metastases.     

Influence of urogenital infections and inflammation on semen quality and male fertility

Background  

Urogenital infections and inflammation are a significant etiologic factor in male infertility.     

Sacral neuromodulation and cardiac pacemakers

Introduction and hypothesis  

Potential for cross-talk between cardiac pacemakers and sacral neuromodulation remains speculative.     

Urinary incontinence in nulliparous women before and during pregnancy: prevalence, incidence, and associated risk factors

Introduction  

Few studies have examined associations of prepregnancy urinary incontinence (UI).     

Clinical features and outcomes of 98 children and adults with dense deposit disease

Background  

Dense deposit disease (DDD) is an ultra-rare renal disease.     

One-year outcome and course of recovery after severe traumatic brain injury

Goal  

To describe the outcome of patients with severe traumatic brain injury (TBI) 3, 6 and 12 months after trauma.     

The accuracy of a novel self-tapping bone fiducial marker for frameless robot-assisted stereo-electro-encephalography implantation and registration techniques

Background

We aimed to evaluate the accuracy and safety of a novel self-tapping bone fiducial as a registration technique for stereoelectroencephalography (SEEG) implantation.

Methods

Each patient was installed with five bone fiducial markers. All procedures were performed using the same Sinovation robot system. The accuracy was determined by calculating the target point error (TPE) and the entry point error (EPE) of electrodes.

Results

Fourteen patients underwent SEEG implantation surgery; and the average installation time of the markers per patient was 86.1 s. In the operating theatre, the average registration time was 206.6 s, and the average registration error was 0.18 mm. The average TPE of 174 electrodes was 1.98 mm and the average EPE was 0.88 mm.

Conclusion

Our study provided a bone fiducial marker installation and registration technique that was convenient and fast, highly accurate in registration, and highly tolerated by patients.     

Bleeding and Thromboembolic Outcomes for Patients on Oral Anticoagulation Undergoing Elective Colon and Rectal Abdominal Operations

Purpose  

Patients on chronic oral anticoagulation can be challenging to manage in the perioperative period.     

Towards a diagnostic and therapeutic consensus in male osteoporosis

Summary  

The consensus views on osteoporosis in men are reported.     

Occult hip and pelvic fractures and accompanying muscle injuries around the hip

Method  

We investigated the incidence of occult hip and pelvic fractures and associated muscle injuries around the hip.     

Triceps tears in athletes: different injury patterns and surgical treatment

Introduction  

Triceps muscle tears requiring surgical treatment are uncommon injuries.     

Carpal tunnel syndrome and the use of computer mouse and keyboard: A systematic review

Background  

This review examines evidence for an association between computer work and carpal tunnel syndrome (CTS).     

Laparoscopic and Open Abdominoperineal Resection for Cancer: How Patient Selection and Complications Differ by Approach

Background  

Outcomes between laparoscopic (LAPR) and open abdominoperineal resections (OAPR) are poorly described.     

Endotoxin elimination in sepsis: physiology and therapeutic application

Purpose  

The present review summarizes key papers on the elimination of endotoxin in human.     

Sciatica presenting as post-amputation neuroma: presentation and clinical findings

Study design  

Case report, level-5 evidence.