No frugal innovation without frugal evaluation: the Global IDEAL Sub-Framework.

Objective: The Global IDEAL Sub-Framework Study aimed to combine the intended effects of the 2009/2019 IDEAL (Idea, Development, Exploration, Assessment, Long-term study) Framework recommendations on evaluating surgical innovation with the vision outlined by the 2015 Lancet Commission on Global Surgery to provide recommendations for evaluating surgical innovation in low-resource environments.

Design: A mixture of methods including an online global survey and semistructured interviews (SSIs). Quantitative data were summarized with descriptive statistics and qualitative data were analyzed using the Framework Method.

Virtual reality technology for surgical learning: qualitative outcomes of the first virtual reality training course for emergency and essential surgery delivered by a UK-Uganda partnership.

Introduction: The extensive resources needed to train surgeons and maintain skill levels in low-income and middle-income countries (LMICs) are limited and confined to urban settings. Surgical education of remote/rural doctors is, therefore, paramount. Virtual reality (VR) has the potential to disseminate surgical knowledge and skill development at low costs.

Personalising intravenous to oral antibiotic switch decision making through fair interpretable machine learning.

Antimicrobial resistance (AMR) and healthcare associated infections pose a significant threat globally. One key prevention strategy is to follow antimicrobial stewardship practices, in particular, to maximise targeted oral therapy and reduce the use of indwelling vascular devices for intravenous (IV) administration. Appreciating when an individual patient can switch from IV to oral antibiotic treatment is often non-trivial and not standardised.

Effect of neurosurgical high observation beds (HOBs) on service provision: a single-centre experience and cost analysis.

Objective: To evaluate the effect of level 1, high observation beds (HOBs) compared with high dependency unit (HDU) and neurosurgical intensive care unit (NICU) admission on service provision, such as cancelled operations, and healthcare costs.

Methods: A retrospective, observational, single-centre cross-sectional study at a single, large UK neurosurgical centre. All adult patients admitted to neurosurgical HOBs between December 2021 and July 2022 were included.

Utilising an accelerated Delphi process to develop consensus on the requirement and components of a pre-procedural core robotic surgery curriculum.

Robot-assisted surgery (RAS) continues to grow globally. Despite this, in the UK and Ireland, it is estimated that over 70% of surgical trainees across all specialities have no access to robot-assisted surgical training (RAST). This study aimed to provide educational stakeholders guidance on a pre-procedural core robotic surgery curriculum (PPCRC) from the perspective of the end user; the surgical trainee.

Machine learning and synthetic outcome estimation for individualised antimicrobial cessation.

The decision on when it is appropriate to stop antimicrobial treatment in an individual patient is complex and under-researched. Ceasing too early can drive treatment failure, while excessive treatment risks adverse events. Under- and over-treatment can promote the development of antimicrobial resistance (AMR).

There is a great variety of orthopaedic conditions presenting to a large hospital in Sierra Leone: a 3-year prospective study.

Purpose: In Sierra Leone there is a large void in orthopaedic research into the type of orthopaedic injuries, both acute and chronic. Improved data collection is essential in providing insight to guide health care planning and research. This study aims to outline the types of orthopaedic injury sustained.

Day 2 neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios for prediction of delayed cerebral ischemia in subarachnoid hemorrhage.

Objective: Recent evidence has suggested that an admission neutrophil-to-lymphocyte ratio (NLR) of ≥ 5.9 predicts delayed cerebral ischemia (DCI) in aneurysmal subarachnoid hemorrhage (aSAH). The primary aims of this study were to assess reproducibility and to ascertain the predictive ability of NLR on subsequent days postictus.

Impact of surgical drain output monitoring on patient outcomes in hepatopancreaticobiliary surgery: A systematic review.

Background And Objective: Surgical drains are widely utilized in hepatopancreaticobiliary surgery to prevent intra-abdominal collections and identify postoperative complications. Surgical drain monitoring ranges from simple-output measurements to specific analysis for constituents such as amylase. This systematic review aimed to determine whether surgical drain monitoring can detect postoperative complications and impact on patient outcomes.

What factors shape surgical access in West Africa? A qualitative study exploring patient and provider experiences of managing injuries in Sierra Leone.

Introduction: Surgical access is central to universalising health coverage, yet 5 billion people lack timely access to safe surgical services. Surgical need is particularly acute in post conflict settings like Sierra Leone. There is limited understanding of the barriers and opportunities at the service delivery and community levels.

Barriers to accessing and providing rehabilitation after a lower limb amputation in Sierra Leone - a multidisciplinary patient and service provider perspective.

Purpose: The primary aim was to explore the perceived barriers that lower limb amputees and service providers face when accessing or providing rehabilitation services. The secondary aim was to describe the lower limb amputations performed in public hospitals in the Western Area of Sierra Leone in 2018.

Materials And Methods: A mixed methodology was employed, involving the collection of amputation data from surgical logbooks and interviews with amputees ( = 10) and group discussion and interviews with service providers ( = 11).

Delayed Gastric Emptying Post-Esophagectomy: A Single-Institution Experience.

Objective: Delayed gastric emptying (DGE) is a common functional disorder after esophagectomy in patients with esophageal carcinoma. Management of DGE varies widely and it is unclear how comorbidities influence the postoperative course. This study sought to determine factors that influence postoperative DGE.

Global academic response to COVID-19: Cross-sectional study.

Unlabelled: This study explores the response to COVID-19 from investigators, editors, and publishers and seeks to define challenges during the early stages of the pandemic. A cross-sectional bibliometric review of COVID-19 literature was undertaken between 1 November 2019 and 24 March 2020, along with a comparative review of Middle East respiratory syndrome (MERS) literature. Investigator responsiveness was assessed by measuring the volume and type of research published.

Robotic resection of an esophageal leiomyoma.

The use of robotic thoracic surgery as an alternative to open resections or video assisted thoracoscopy has increased in recent years due to its many potential benefits to patients. These benefits include less pain and therefore less use of pain medication, shorter hospital stays, faster recovery, and fewer complications.  This video tutorial describes the robotic resection of a 37-mm by 30-mm esophageal leiomyoma.

The Incidence of Low Anterior Resection Syndrome as Assessed in an International Randomized Controlled Trial (MRC/NIHR ROLARR).

Objective: To investigate the incidence of LARS in patients undergoing elective anterior resection within the MRC/NIHR ROLARR trial and to explore perioperative variables that might be associated with major LARS.

Summary Background Data: Sphincter-preserving rectal cancer surgery is frequently accompanied by defaecatory dysfunction known as Low anterior resection syndrome (LARS). This is distressing for patients and is an unmet clinical challenge.

Management of Lung Cancer with Concomitant Cardiac Disease.

This article discusses the numerous issues surrounding lung cancer treatment in patients with concomitant cardiac disease. It also addresses the preoperative work-up of these patients and the specifics of surgical intervention.