Keep it simple: a crosshair on the screen during proctored laparoscopic surgeries.

Introduction: Inside the operating room, experts use verbal instructions to guide surgical novices through laparoscopic procedures. In this study, we evaluated the use of a crosshair attached to the video monitor, as a hands-free pointing tool to simplify instructions during operation.

Methods: Ten surgical novices performed two elective laparoscopic cholecystectomies within a week of each other, randomized such that one was performed with and the other without using the crosshair.

Radiation therapy of breast cancer in the Nahe Breast Center: first results of an analysis in the context of health services research.

Background: The first evaluation of radiotherapy results in patients with breast cancer treated as part of a multimodal oncologic therapy in the Nahe Breast Center is presented. Analysis of the results was performed using an in-practice registry.

Patients And Methods: From September 2016 to December 2017, 138 patients (median age 62.

Counseling on Complementary Methods in the Treatment of Side Effects of Oncological Therapies: A Project of the Breast and Bowel Center Nahe at the Hospital Sankt Marienwoerth Bad Kreuznach.

Background: Increasingly, patients with cancer are asking for additional, complementary therapy options for treating the side effects of oncological therapy. Thus, the members of the Breast and Bowel Center Nahe at the Sankt Marienwörth Hospital Bad Kreuznach decided to define the content of this type of counseling for patients before treatment.

Methods: In 2018, a team of internal oncologists, gynecological oncologists, radio-oncologists, nutritionists, psycho-oncologists, and study nurses met several times to define the content of counseling.

Using virtual 3D-models in surgical planning: workflow of an immersive virtual reality application in liver surgery.

Purpose: Three-dimensional (3D) surgical planning is widely accepted in liver surgery. Currently, the 3D reconstructions are usually presented as 3D PDF data on regular monitors. 3D-printed liver models are sometimes used for education and planning.

HoloPointer: a virtual augmented reality pointer for laparoscopic surgery training.

Purpose: In laparoscopic surgery training, experts guide novice physicians to desired instrument positions or indicate relevant areas of interest. These instructions are usually given via verbal communication or using physical pointing devices. To facilitate a sterile work flow and to improve training, new guiding methods are needed.

Quality-based assessment of camera navigation skills for laparoscopic fundoplication.

Laparoscopic fundoplication is considered the gold standard surgical procedure for the treatment of symptomatic hiatus hernia. Studies on surgical performance in minimally invasive hiatus hernia repair have neglected the role of the camera assistant so far. The current study was designed to assess the applicability of the structured assessment of laparoscopic assistance skills (SALAS) score to laparoscopic fundoplication as an advanced and commonly performed laparoscopic upper GI procedure.

Local, semi-automatic, three-dimensional liver reconstruction or external provider? An analysis of performance and time expense.

Purpose: In hepatobiliary surgery, preoperative three-dimensional reconstruction based on CT or MRI can be provided externally or by local, semi-automatic software. We analyzed the time expense and quality of external versus local three-dimensional reconstructions.

Methods: Three first-year residents reconstructed data from 20 patients with liver pathologies using a local, semi-automatic, server-based program.

[Variation in morphology or two entities?].

A 37-year-old patient presented with B symptoms. On examination, hypodense liver lesions, multiple enlarged and partly confluent lymph nodes in the upper abdomen and retroperitoneum, as well as disseminated splenic and pulmonary foci were detected. Biopsies of a tumor in the coecum and the liver led to the diagnosis of an adenocarcinoma of the colon.

Higher quality camera navigation improves the surgeon's performance: Evidence from a pre-clinical study.

Introduction: To objectively assess the quality of laparoscopic camera navigation (LCN), the structured assessment of LCN skills (SALAS) score was developed and validated for laparoscopic cholecystectomy. The aim of this pre-clinical study was to investigate the influence of LCN on surgical performance during virtual cholecystectomy (vCHE) using this score.

Methods: A total of 84 medical students were included in this prospective study.

Head-Mounted Mixed-Reality Technology During Robotic-Assisted Transanal Total Mesorectal Excision.

Introduction: Head-mounted mixed-reality technologies may enable advanced intraoperative visualization during visceral surgery. In this technical note, we describe an innovative use of real-time mixed reality during robotic-assisted transanal total mesorectal excision.

Technique: Video signals from the robotic console and video endoscopic transanal approach were displayed on a virtual monitor using a head-up display.

Surgical Resection for Recurrent Intrahepatic Cholangiocarcinoma.

Background: Although after R0 resection of intrahepatic cholangiocarcinoma (ICC) recurrence is frequent, most guidelines do not address strategies for this. The aim of this study was to analyze the outcome of repeated resection and to determine criteria when repeated resection is reasonable.

Methods: Between 2008 and 2016, we consecutively collected all cases of ICC (n = 176) in a prospective database and further analyzed them with a focus on tumor recurrence, its surgical treatment, overall survival and recurrence-free survival.

Artificial Versus Video-Based Immersive Virtual Surroundings: Analysis of Performance and User's Preference.

Introduction: Immersive virtual reality (VR) laparoscopy simulation connects VR simulation with head-mounted displays to increase presence during VR training. The goal of the present study was the comparison of 2 different surroundings according to performance and users' preference.

Methods: With a custom immersive virtual reality laparoscopy simulator, an artificially created VR operating room (AVR) and a highly immersive VR operating room (IVR) were compared.

Highly immersive virtual reality laparoscopy simulation: development and future aspects.

Purpose: Virtual reality (VR) applications with head-mounted displays (HMDs) have had an impact on information and multimedia technologies. The current work aimed to describe the process of developing a highly immersive VR simulation for laparoscopic surgery.

Methods: We combined a VR laparoscopy simulator (LapSim) and a VR-HMD to create a user-friendly VR simulation scenario.

New dimensions in surgical training: immersive virtual reality laparoscopic simulation exhilarates surgical staff.

Introduction: Virtual reality (VR) and head mount displays (HMDs) have been advanced for multimedia and information technologies but have scarcely been used in surgical training. Motion sickness and individual psychological changes have been associated with VR. The goal was to observe first experiences and performance scores using a new combined highly immersive virtual reality (IVR) laparoscopy setup.

Cold-start capability in virtual-reality laparoscopic camera navigation: a base for tailored training in undergraduates.

Background: Frequently medical students have to fulfill the role as the camera operator in laparoscopic procedures. Published work concerning camera navigation skills, especially in medical students, is rare. Therefore, our purpose was to evaluate personal characteristics and abilities that may affect virtual-reality laparoscopic camera navigation (VR-LCN) performance in a large cohort of first-time virtual-reality laparoscopy users.