Background: Limited and heterogeneous literature data necessitate a focused examination of the learning curve in robotic liver resections. This study aims to assess the learning curve of two surgeons from the same team with differing laparoscopic backgrounds.
Methods: Since February 2021, San Raffaele Hospital in Milan has implemented a robotic liver surgery program, performing 250 resections by three trained console surgeons. Using cumulative sum (CUSUM) analysis, the learning curve was evaluated for a Pioneer Surgeon (PS) with around 1200 laparoscopic cases and a New Generation Surgeon (NGS) with approximately 100 laparoscopic cases. Cases were stratified by complexity (38 low, 74 intermediate, 85 high).
Results: Both PS and NGS demonstrated a learning curve for operative time after 15 low-complexity and 10 intermediate-complexity cases, with high-complexity learning curves apparent after 10 cases for PS and 18 cases for NGS. Conversion rates remained unaffected, and neither surgeon experienced increased blood loss or postoperative complications. A "team learning curve" effect in terms of operative time emerged after 12 cases, suggesting the importance of a cohesive surgical team.
Conclusion: The robotic platform facilitated a relatively brief learning curve for low and intermediate complexity cases, irrespective of laparoscopic background, underscoring the benefits of team collaboration.
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http://dx.doi.org/10.1016/j.hpb.2024.10.007 | DOI Listing |
Catheter Cardiovasc Interv
December 2024
Department of Cardiology, Angiology and Intensive Care Medicine, University Heart Center Lübeck, Lübeck, Germany.
Background: The new Amplatzer Steerable Delivery Sheath is a delivery system designed to improve ease-of-use and procedural results of left atrial appendage closure (LAAC). We aimed to compare procedural results after switching our LAAC program at a tertiary care center with the Amulet device to the Steerable Delivery Sheath, with a control group of LAAC employing the standard sheath.
Methods: The first n = 32 consecutively treated patients at our site using the Amulet device with the Steerable Delivery Sheath were included in this retrospective analysis.
Cureus
November 2024
Department of General Surgery, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Background: Laparoscopic cholecystectomy is a standard minimally invasive technique for the treatment in gallstone disease. In difficult laparoscopic cholecystectomies, bailout strategies have been developed of which the fundus-first technique is one. The present study aims to compare the outcomes of the fundus-first technique against the standard laparoscopic approach in managing difficult cholecystectomy cases by focusing on intraoperative factors such as bleeding, bile duct injury, operative time, and postoperative complications like biliary leakage.
View Article and Find Full Text PDFFront Immunol
December 2024
Department of ophthalmology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China.
Background: This study examined the interhemispheric integration function pattern in patients with iridocyclitis utilizing the voxel-mirrored homotopic connectivity (VMHC) technique. Additionally, we investigated the ability of VMHC results to distinguish patients with iridocyclitis from healthy controls (HCs), which may contribute to the development of objective biomarkers for early diagnosis and intervention in clinical set.
Methods: Twenty-six patients with iridocyclitis and twenty-six matched HCs, in terms of sex, age, and education level, underwent resting-state functional magnetic resonance imaging (fMRI) examinations.
Arch Razi Inst
June 2024
Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran.
In the present study, the mechanisms involved in scopolamine-induced memory impairment have been investigated. The molecular events that take place during memory mostly include mechanisms that are seen in the acquisition phase. Results showed that one of the mechanisms of memory destruction caused by scopolamine, in addition to weakening the cholinergic system, is the indirect effect of scopolamine on other neurotransmitter systems, including the glutamatergic system.
View Article and Find Full Text PDFRadiat Oncol
December 2024
Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
Background And Purpose: Timely identification of local failure after stereotactic radiotherapy for brain metastases allows for treatment modifications, potentially improving outcomes. While previous studies showed that adding radiomics or Deep Learning (DL) features to clinical features increased Local Control (LC) prediction accuracy, their combined potential to predict LC remains unexplored. We examined whether a model using a combination of radiomics, DL and clinical features achieves better accuracy than models using only a subset of these features.
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