Surgical reporting for laparoscopic cholecystectomy based on phase annotation by a convolutional neural network (CNN) and the phenomenon of phase flickering: a proof of concept.

Purpose: Surgical documentation is an important yet time-consuming necessity in clinical routine. Beside its core function to transmit information about a surgery to other medical professionals, the surgical report has gained even more significance in terms of information extraction for scientific, administrative and judicial application. A possible basis for computer aided reporting is phase detection by convolutional neural networks (CNN).

Emergency Telemedicine Mobile Ultrasounds Using a 5G-Enabled Application: Development and Usability Study.

Background: Digitalization affects almost every aspect of modern daily life, including a growing number of health care services along with telemedicine applications. Fifth-generation (5G) mobile communication technology has the potential to meet the requirements for this digitalized future with high bandwidths (10 GB/s), low latency (<1 ms), and high quality of service, enabling wireless real-time data transmission in telemedical emergency health care applications.

Objective: The aim of this study is the development and clinical evaluation of a 5G usability test framework enabling preclinical diagnostics with mobile ultrasound using 5G network technology.

Systematic Review and Meta-Analysis on Colorectal Anastomotic Techniques.

Purpose: Anastomosis creation after resective gastrointestinal surgery is a crucial task. The present review examines the techniques and implants currently available for anastomosis creation and analyses to which extent they already address our clinical needs, with a special focus on their potential to enable further trauma minimization in visceral surgery.

Methods: A multi-database research was conducted in MEDLINE, Scopus, and Cochrane Library.

"Hybrid" scientific conference: lessons learned from the digital annual meeting of the CARS international conference during the Covid-19 pandemic.

Objectives: Due to the coronavirus disease 2019 (Covid-19) pandemic, all scientific conferences in the year 2020 had to be adapted in their form of presence to accommodate for safety regulations, postponed, or canceled entirely. As organizers of the annual Computer Assisted Radiology & Surgery International Conference & Exhibition (CARS)-Conference 2020, we decided to hold a "hybrid" conference, i.e.

RAY-POS: a LIDAR-based assistance system for intraoperative repositioning of mobile C-arms without external aids.

Purpose: In current clinical practice, intraoperative repositioning of mobile C-arms is challenging due to a lack of visual cues and efficient guiding tools. This can be detrimental to the surgical workflow and lead to additional radiation burdens for both patient and personnel. To overcome this problem, we present our novel approach Lidar-based X-ray Positioning for Mobile C-arms (RAY-POS) for assisting circulating nurses during intraoperative C-arm repositioning without requiring external aids.

The hospital of the future: rethinking architectural design to enable new patient-centered treatment concepts.

Purpose: Today's hospitals are designed as collections of individual departments, with limited communication and collaboration between medical sub-specialties. Patients are constantly being moved between different places, which is detrimental for patient experience, overall efficiency and capacity. Instead, we argue that care should be brought to the patient, not vice versa, and thus propose a novel hospital architecture concept that we refer to as Patient Hub.

Telemedical percussion: objectifying a fundamental clinical examination technique for telemedicine.

Purpose: While demand for telemedicine is increasing, patients are currently restricted to tele-consultation for the most part. Fundamental diagnostics like the percussion still require the in person expertize of a physician. To meet today's challenges, a transformation of the manual percussion into a standardized, digital version, ready for telemedical execution is required.

New Method for Surgical Diagnostics - a Robotic Telemedical Approach.

Apart from the tremendous increase in the demand for telemedicine during the COVID-19 pandemic, the use of telemedical technology offers many advantages, such as better coverage of rural areas and improved access to specialists. While current telediagnostic possibilities are often limited to a verbal consultation, the field of surgery has already made use of robotics for one of the most challenging areas of medicine: invasive procedures. Since comprehensive diagnostics are a prerequisite for each surgery, we built upon the knowledge gained in telesurgery and developed a telediagnostic system that allows for an extensive perioperative and emergency examination.

COVID-19 and beyond: development of a comprehensive telemedical diagnostic framework.

Purpose: During the COVID-19 pandemic, a threatening bottleneck of medical staff arose due to a shortage of trained caregivers, who became infected while working with infectious patients. While telemedicine is rapidly evolving in the fields of teleconsultation and telesurgery, proper telediagnostic systems are not yet available, although the demand for contactless patient-doctor interaction is increasing.

Methods: In this project, the current limitations were addressed by developing a comprehensive telediagnostic system.

Ventilatory Response to Hypercapnia as Experimental Model to Study Effects of Oxycodone on Respiratory Depression.

Background: Opioid analgesics used to treat pain can cause respiratory depression. However, this effect has not been extensively studied, and life-threatening, opioid-induced respiratory depression remains difficult to predict. We tested the ventilatory response to hypercapnia for evaluating the pharmacodynamic effect of a drug on respiratory depression.

How to Cope with Big Data in Functional Analysis of the Esophagus.

Introduction: Esophageal motility disorders have a severe impact on patients' quality of life. While high-resolution manometry (HRM) is the gold standard in the diagnosis of esophageal motility disorders, intermittently occurring muscular deficiencies often remain undiscovered if they do not lead to an intense level of discomfort or cause suffering in patients. Ambulatory long-term HRM allows us to study the circadian (dys)function of the esophagus in a unique way.

Rabbits transgenic for human IgG genes recapitulating rabbit B-cell biology to generate human antibodies of high specificity and affinity.

Transgenic animals incorporating human antibody genes are extremely attractive for drug development because they obviate subsequent antibody humanization procedures required for therapeutic translation. Transgenic platforms have previously been established using mice, but also more recently rats, chickens, and cows and are now in abundant use for drug development. However, rabbit-based antibody generation, with a strong track record for specificity and affinity, is able to include gene conversion mediated sequence diversification, thereby enhancing binder maturation and improving the variance/selection of output antibodies in a different way than in rodents.

Evaluation of long-term stability of monolithic 3D-printed robotic manipulator structures for minimally invasive surgery.

Purpose: In the era of patient-centered medicine, clinical procedures, tools and instruments should be individually adapted to the patient. In this context, the presented 3D-printed Single-Port Overtube Manipulator System follows the aims to provide patient- and task-specific disposable manipulators for minimally invasive surgery. In a first experiment, the robustness of the monolithic flexure hinge structures in use as robotic manipulators will be investigated.

Machine Learning in the OR: A Collaborative Environment for Surgical Interventions in Visceral Medicine.

Modern surgical methods are becoming increasingly sophisticated and the number of technical devices that are used during these interventions is increasing. However, the surgical operating room (OR) remains a mere conglomerate of unconnected medical devices. The increase in the complexity of device functionality, in addition to the demands of surgery, pushes human mental capacity to its limit.

Acoustic signal analysis of instrument-tissue interaction for minimally invasive interventions.

Purpose: Minimally invasive surgery (MIS) has become the standard for many surgical procedures as it minimizes trauma, reduces infection rates and shortens hospitalization. However, the manipulation of objects in the surgical workspace can be difficult due to the unintuitive handling of instruments and limited range of motion. Apart from the advantages of robot-assisted systems such as augmented view or improved dexterity, both robotic and MIS techniques introduce drawbacks such as limited haptic perception and their major reliance on visual perception.

Efficiency of Electropumping in Nanochannels.

Electropumping has been shown to be an effective means of inducing a net positive flow in fluids confined within planar nanochannels and carbon nanotubes. In this Letter, we investigate the efficiency of electropumping relative to Couette and Poiseuille flows. We apply a spatially uniform rotating electric field to a fluid confined in a functionalized nanochannel that couples the water's permanent dipole moment resulting in a net positive flow.

MIEO: a micro-invasive endoscopic operation port system for transluminal interventions-an acute and survival porcine study.

Background: A reliable and sterile access through the intestinal wall to ease flexible endoscopic transluminal interventions is still appealing but lacks a suitable port system.

Methods: In a granted industry cooperation, we developed the MIEO-Port, a flexible three components overtube system that provides a temporary hermetic sealing of the intestinal wall to allow endoscopic disinfection and manipulation to gain access to the abdominal cavity. The port features an innovative head part which allows for coupling the port to the intestinal wall by vacuum suction and for controlled jetting the isolated intestinal surface with a disinfectant.

Integrating autonomously navigating assistance systems into the clinic: guiding principles and the ANTS-OR approach.

Purpose: Autonomously self-navigating clinical assistance systems (ASCAS) seem highly promising for improving clinical workflows. There is great potential for easing staff workload and improving overall efficiency by reducing monotonous and physically demanding tasks. However, a seamless integration of such systems into complex human-supervised clinical workflows is challenging.

[Artificial intelligence in general and visceral surgery].

Artificial intelligence procedures will find special fields of application also in general and visceral surgery. These will not only be limited to intraoperative surgical applications but also extend to perioperative processes, education and training as well as to future scientific developments. Major impulses are to be expected in decision support systems, cognitive collaborative interventional environments and in evidence-based knowledge acquisition models; however, the implementation into the daily practice not only requires profound insights into the field of informatics and computer science but also a comprehensive knowledge of the surgical domain.

5th-Generation Mobile Communication: Data Highway for Surgery 4.0.

Introduction: 5th generation cellular mobile communications (5G) is one of the main requirements for the digital future. The new standard will offer high bandwidths (10GB/s), low latency (<1ms), and a high quality of service. It is not yet known whether 5G performance is sufficient for demanding eHealth applications (e.

[Digitalization in surgery : What surgeons currently think and know about it-results of an online survey].

Background: The digitalization process is currently on everyone's lips and sweeping changes in the field of public health and especially in surgery are to be expected within the next few years. Besides general issues, such as electronic health records and medical information systems, artificial intelligence, robotics and model-based surgery will decisively impact on the daily routine. In order to provide the necessary knowledge base, to point out related risks and chances and also to define fields of action for surgery, the German Society of Surgery commissioned a position paper on digitalization.

Inducing a Net Positive Flow of Water in Functionalized Concentric Carbon Nanotubes Using Rotating Electric Fields.

Electropumping has shown great potential as an effective means of inducing a net positive flow of water in confined channels. In this paper we present the first nonequilibrium molecular dynamics study and continuum based numerical solutions that demonstrate an effective net positive flow between concentric carbon nanotubes (CNT) using electropumping. We apply a spatially uniform rotating electric field that couples to the water's permanent dipole moment.

Mechatronic Support System for NOTES and Monoport Surgery - A New Approach.

To circumvent the drawbacks of currently available platforms for natural orifice transluminal endoscopic surgery (NOTES) and monoport surgery (MPS), we developed a patient-specific, disposable, surgical soft robotic system. The system (Single-Port Overtube; SPOT) is designed as an overtube for standard surgical equipment. The platform body and the manipulators can be quickly adapted to transmural (monoport), NOTES and endoluminal (endoscopic) applications, and 3D-printed overnight as an individualized system.

[Model-based treatment in surgery].

Background: The "magic triangle" in surgery and other disciplines consists of the demand for increasingly gentler forms of treatment, simultaneous cost reduction and the fundamental primacy of improving the quality of results. The digitalization of medicine offers a promising opportunity to do justice to this, also in the sense of "Surgery 4.0".