Augmenting Robot-Assisted Pattern Cutting with Periodic Perturbations-Can We Make Dry Lab Training More Realistic?

Objective: Teleoperated robot-assisted minimally-invasive surgery (RAMIS) offers many advantages over open surgery, but RAMIS training still requires optimization. Existing motor learning theories could improve RAMIS training. However, there is a gap between current knowledge based on simple movements and training approaches required for the more complicated work of RAMIS surgeons.

Personalizing non-small cell lung cancer treatment through patient-derived xenograft models: preclinical and clinical factors for consideration.

Purpose: In the pursuit of creating personalized and more effective treatment strategies for lung cancer patients, Patient-Derived Xenografts (PDXs) have been introduced as preclinical platforms that can recapitulate the specific patient's tumor in an in vivo model. We investigated how well PDX models can preserve the tumor's clinical and molecular characteristics across different generations.

Methods: A Non-Small Cell Lung Cancer (NSCLC) PDX model was established in NSG-SGM3 mice and clinical and preclinical factors were assessed throughout subsequent passages.

Empyema Secondary to Pneumonia: Whom Should We Operate?

Empyema secondary to pneumonia is a common condition. A significant number of patients will require surgical intervention for drainage and decortication. The aim of this study was to identify predictive factors for surgical intervention.

Thoracic surgery in Israel.

During the past 74 years since its establishment, Israel has evolved into a modernized country with well-established and effective public health care system. Thoracic surgeons in Israel play a central role in the diagnosis and treatment of patients with diseases of the chest wall, diaphragm, mediastinum, airways, Lung, and esophagus as well are taking part in designated trauma teams. Between 2,500-3,000 cases are being performed in 16 designated thoracic surgical units and departments across the country annually, the majority of them being performed in a minimally invasive fashion.

Serratus Anterior Block for Long-Term Post-Thoracoscopy Pain Management.

Purpose: Neuropathic, chronic pain is a common and severe complication following thoracic surgery, known as post-thoracotomy pain syndrome (PTPS). Here we evaluated the efficacy of an ultrasound-guided serratus anterior plane block (SAPB) on pain control compared to traditional pain management with intravenous opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) six months after thoracic surgery.

Patients And Methods: In this retrospective observational study, we analyzed data from a questionnaire survey.

Generalization of Deep Learning Gesture Classification in Robotic-Assisted Surgical Data: From Dry Lab to Clinical-Like Data.

Objective: Robotic-assisted minimally invasive surgery (RAMIS) became a common practice in modern medicine and is widely studied. Surgical procedures require prolonged and complex movements; therefore, classifying surgical gestures could be helpful to characterize surgeon performance. The public release of the JIGSAWS dataset facilitates the development of classification algorithms; however, it is not known how algorithms trained on dry-lab data generalize to real surgical situations.

Epithelioid Hemangioendothelioma and Epithelioid Hemangioma: Pazopanib as a Potential Salvage Therapy.

Epithelioid hemangioma (EH) and epithelioid hemangioendothelioma (EHE) are both rare vascular tumors. EH tumors are often benign while EHE tumors have moderate malignant potential. Here, we present three unique cases at Soroka Medical Center, two featuring EH of the bone and one presenting EHE of the mediastinum.

Clinical outcomes of critically ill multiple trauma patients with rib fractures. A prospective study with retrospective control.

Introduction: Rib fracture fixation is becoming more popular and widely accepted among trauma surgeons worldwide as the recommended treatment method for flail chest injury. Recent data demonstrate improved results when compared with non-operative treatment. Improved outcomes were reported regarding ICU stay, need for tracheostomy, length of hospital stay, ventilator-associated pneumonia (VAP), and even death.

A Huge Hydatid Pulmonary Cyst.

This case report describes a patient with an unusually large pulmonary hydatid cyst and discusses important management issues.

Predictors of survival after emergency department thoracotomy in trauma patients with predominant thoracic injuries in Southern Israel: a retrospective survey.

Emergency department thoracotomy (EDT), also termed "resuscitative thoracotomy", is indicated in some cases of life-threatening isolated thoracic injury, or as a part of CPR (cardiopulmonary resuscitation) in multiple trauma patients, or in thoracic trauma patients with massive bleeding (such as intra-abdominal exsanguination or injury to the great vessels). There is a lack of information in the literature concerning predictors of survival after EDT in patients with predominant or isolated thoracic trauma. The study was retrospective and single-center.

Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery.

Background: Patients who undergo surgical procedures that impair the integrity of the chest wall frequently experience extremely severe postoperative pain. Opiates and weaker analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are not sufficiently effective in achieving control of severe pain and might cause respiratory and gastrointestinal complications. In the past decade, there has been an increased interest in the use of regional nerve blocks for post-thoracoscopy and post-thoracotomy analgesia.

Peripheral blood telomere alterations in ground glass opacity (GGO) lesions may suggest malignancy.

A ground glass opacity (GGO) lung lesion may represent early stage adenocarcinoma, which has an excellent prognosis upon prompt surgical resection. However, GGO lesions have broad differential diagnoses, including both benign and malignant lesions. Our objective was to study telomere length and telomerase activity in patients with suspected lung cancer in which GGO was the predominant radiographic feature.

In-situ left-sided bilateral internal thoracic artery: elevated hemidiaphragm.

Background Procurement of the internal thoracic artery risks ipsilateral phrenic nerve injury and elevated hemidiaphragm. Anatomical variations increase the risk on the right side. Patients receiving left-sided in-situ right internal thoracic artery configurations appear to be at greatest risk.

A molecular signature of lung cancer: potential biomarkers for adenocarcinoma and squamous cell carcinoma.

Adenocarcinoma (AC) and squamous cell carcinoma (SCC), sub-types of non-small cell lung cancer (NSCLC), both present unique features at the genome, epigenome, transcriptome and proteome levels, as well as shared clinical and histopathological characteristics, but differ in terms of treatment. To ensure proper treatment, one must be able to distinguish between these sub-types. Here, we identify novel biomarker proteins in NSCLC, allowing for distinguishing between the AC and SCC sub-types.

Clinical Outcome of Urgent Thoracotomy in Patients with Penetrating and Blunt Chest Trauma: A Retrospective Survey.

Introduction: In contrast to an emergency department of thoracotomy (EDT), an urgent thoracotomy (UT) is defined as a surgical thoracic intervention performed in the operating room within the first 48 hours of the patient's intensive care unit (ICU) stay. The factors affecting survival after UT are not fully understood. In this study, we retrospectively analyzed the clinical data and outcome of patients with blunt and penetrating chest injuries who underwent UT.

Deep Neck Infection and Descending Mediastinitis as a Complication of Propionibacterium acnes Odontogenic Infection.

Propionibacterium acnes is an anaerobic, Gram-positive bacterium which causes numerous types of infections. Isolated Propionibacterium acnes deep neck infections are very rare. We present an interesting case of deep neck infection complicated by descending mediastinitis of isolated Propionibacterium acnes infection.

Two Paraneoplastic Autoimmune Syndromes: Limbic Encephalitis and Palmar Fasciitis in a Patient with Small Cell Lung Cancer.

Small cell lung cancer (SCLC) is characterized by a relatively high rate of autoimmune phenomena. Paraneoplastic limbic encephalitis (PLE) is an autoimmune syndrome in which a non-neural tumor containing an antigen normally present in the nervous system precipitates an antibody attack on neural tissues. Patients with PLE usually present with rapidly progressive short-term memory deficits, confusion or even dementia.

Silencing VDAC1 Expression by siRNA Inhibits Cancer Cell Proliferation and Tumor Growth In Vivo.

Alterations in cellular metabolism and bioenergetics are vital for cancer cell growth and motility. Here, the role of the mitochondrial protein voltage-dependent anion channel (VDAC1), a master gatekeeper regulating the flux of metabolites and ions between mitochondria and the cytoplasm, in regulating the growth of several cancer cell lines was investigated by silencing VDAC1 expression using small interfering RNA (siRNA). A single siRNA specific to the human VDAC1 sequence at nanomolar concentrations led to some 90% decrease in VDAC1 levels in the lung A549 and H358, prostate PC-3, colon HCT116, glioblastoma U87, liver HepG2, and pancreas Panc-1 cancer cell lines.

Two-year follow-up in patients treated with emphysematous lung sealant for advanced emphysema.

Endoscopic lung volume-reduction therapy for emphysema has been associated with therapeutic responses smaller in magnitude and less durable than surgical volume reduction (LVRS). Bronchoscopic emphysematous lung sealant (ELS) therapy has been shown to produce improvements in pulmonary function similar to surgery at 1 year. This case series summarizes safety and efficacy data of all patients from the initial ELS study out to 2 years.

Resection and heated pleural chemoperfusion in patients with thymic epithelial malignant disease and pleural spread: a single-institution experience.

Objective: Our objective was to evaluate whether resection and heated pleural chemoperfusion (HPCP) is an effective treatment for de novo stage IVa thymoma (DNT) and thymic carcinoma (TC) and for thymoma with pleural relapse (TPR).

Methods: A retrospective study was conducted of patients undergoing resection and HPCP in 1 center. HPCP with cisplatinum ± doxorubicin (adriamycin) was performed for 60 minutes using a standard roller pump and a modified heat exchanger to a maximal intrapleural temperature of 43°C.

Bilateral endoscopic sealant lung volume reduction therapy for advanced emphysema.

Background: A clinical study was performed to assess the safety and efficacy of bilateral AeriSeal Emphysematous Lung Sealant System (ELS) treatment in patients with advanced emphysema out to 1 year.

Methods: Twenty patients received treatment at four subsegments, two in each upper lobe. Tenhad upper lobe disease, and 10 had homogeneous disease.