Background: A computer vision (CV) platform named EndoDigest was recently developed to facilitate the use of surgical videos. Specifically, EndoDigest automatically provides short video clips to effectively document the critical view of safety (CVS) in laparoscopic cholecystectomy (LC). The aim of the present study is to validate EndoDigest on a multicentric dataset of LC videos.
Methods: LC videos from 4 centers were manually annotated with the time of the cystic duct division and an assessment of CVS criteria. Incomplete recordings, bailout procedures and procedures with an intraoperative cholangiogram were excluded. EndoDigest leveraged predictions of deep learning models for workflow analysis in a rule-based inference system designed to estimate the time of the cystic duct division. Performance was assessed by computing the error in estimating the manually annotated time of the cystic duct division. To provide concise video documentation of CVS, EndoDigest extracted video clips showing the 2 min preceding and the 30 s following the predicted cystic duct division. The relevance of the documentation was evaluated by assessing CVS in automatically extracted 2.5-min-long video clips.
Results: 144 of the 174 LC videos from 4 centers were analyzed. EndoDigest located the time of the cystic duct division with a mean error of 124.0 ± 270.6 s despite the use of fluorescent cholangiography in 27 procedures and great variations in surgical workflows across centers. The surgical evaluation found that 108 (75.0%) of the automatically extracted short video clips documented CVS effectively.
Conclusions: EndoDigest was robust enough to reliably locate the time of the cystic duct division and efficiently video document CVS despite the highly variable workflows. Training specifically on data from each center could improve results; however, this multicentric validation shows the potential for clinical translation of this surgical data science tool to efficiently document surgical safety.
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http://dx.doi.org/10.1007/s00464-022-09112-1 | DOI Listing |
Int J Surg Case Rep
January 2025
Department of Upper Gastrointestinal/Hepatobiliary Surgery, Western Hospital, Footscray, VIC 3011, Australia.
Introduction: Haemobilia causing obstructive jaundice is a rare complication with most occurrences reported post instrumentation e.g. endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangioagraphy (PTC) and, trans-cystic duct exploration or due to hepatic tree pseudoaneurysms.
View Article and Find Full Text PDFBMC Cancer
January 2025
Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Background: Malignant salivary gland tumors (SGTs) present diagnostic challenges and limited treatment options. This study aims to determine the proportion of malignant SGTs overexpressing the androgen receptor (AR) by immunohistochemistry (IHC) and its association to age, sex, anatomical site, histopathological subtype and grade which may inform customized treatment approaches.
Methodology: This was a retrospective cross-sectional analytical study of archived paraffin embedded tissue blocks of malignant SGTs diagnosed at MNH Central Pathology Laboratory (CPL) from January 2019 to December 2022.
Medicina (Kaunas)
November 2024
HPB Unit, Department of Surgery, University Hospital of Ioannina, 455 00 Ioannina, Greece.
: Laparoscopic cholecystectomy (LC) is the most commonly performed operation in general surgery in the Western World. Gallbladder surgery, although most of the time simple, always offers the possibility of unpleasant surprises. Despite progress, the incidence of common bile duct injury is 0.
View Article and Find Full Text PDFJ Clin Med
December 2024
Gastroenterology and Gastrointestinal Endoscopy Division, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132 Milan, Italy.
Endoscopic ultrasound (EUS)-guided interventions have revolutionized the management of malignant biliary obstruction (MBO) and gastric outlet obstruction (GOO), providing minimally invasive alternatives with improved outcomes. These procedures have significantly reduced the need for high-risk surgical interventions or percutaneous alternatives and have provided effective palliative care for patients with advanced gastrointestinal and bilio-pancreatic malignancies. EUS-guided biliary drainage (EUS-BD) techniques, including hepaticogastrostomy (EUS-HGS), choledochoduodenostomy (EUS-CDS), and antegrade stenting (EUS-AS), offer high technical and clinical success rates, with a good safety profile particularly when Endoscopic Retrograde Cholangiopancreatography (ERCP) is not feasible.
View Article and Find Full Text PDFPathologica
October 2024
Pancreatic and Digestive Endocrine Surgical Research Group, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.
An asymptomatic 79-year old woman presented with a 40 mm pancreatic cystic lesion, located in the pancreatic body-tail and consistent with branch-duct intraductal papillary mucinous neoplasm (BD-IPMN) without "high risk stigmata". During a 4-year follow-up period, imaging showed no mural nodules or main pancreatic duct dilation, and serum CEA and CA19.9 were within normal range.
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