A novel minimally invasive neurosurgical cranial fixation device for improved accuracy of intraventricular catheter placement: an experimental animal study.

Background: External ventricular drain (EVD) insertion is one of the most commonly performed neurosurgical procedures. Herein, we introduce a new concept of a cranial fixation device for insertion of EVDs, that reduces reliance on freehand placement and drilling techniques and provides a simple, minimally invasive approach that provides strong fixation to minimal thickness skulls.

Methods: An experimental device for catheter insertion and fixation was designed and tested in both ex-vivo and in-vivo conditions to assess accurate cannulation of the ventricle and to test the strength of fixation to the skull.

Correlation Study and Predictive Modelling of Ergonomic Parameters in Robotic-Assisted Laparoscopic Surgery.

Background: This study aims to continue research on the objective analysis of ergonomic conditions in robotic-assisted surgery (RAS), seeking innovative solutions for the analysis and prevention of ergonomic problems in surgical practice.

Methods: Four different robotic-assisted tasks were performed by groups of surgeons with different surgical experiences. Different wearable technologies were used to record surgeons' posture and muscle activity during surgical practice, for which the correlation between them was analyzed.

Validation of a training simulator for temporomandibular joint arthroscopy.

Objective: This study aims to evaluate a temporomandibular joint (TMJ) arthroscopy simulator using construct and face analyses.

Methods: Thirty participants attending a TMJ training course were divided into novice and expert surgeons (more than 100 procedures) and performed two arthroscopic tasks (cavity access/cavity exploration) during which the surgical tool movements were tracked. Five objective metrics were used to measure surgeon ability and construct validity was assessed by comparing novel and expert performance.

Assessing the Use of Virtual Pointers in Laparoscopic Surgery Training Activities.

Background: Laparoscopic surgery has advanced significantly; however, effective communication within the surgical team remains challenging, particularly in training scenarios where misinterpretation of instructions can lead to errors. Virtual pointers, indicating the instructor's gaze through eye-tracking devices and overlaying it onto the screen using augmented reality (AR), can enhance understanding and reduce errors.

Methods: In a study involving 10 participants divided into experts and novices in laparoscopic surgery, various pointers (differing in shape, size and colour) were analysed in an AR environment using the HoloLens2 device.

The IMproving Preclinical Assessment of Cardioprotective Therapies (IMPACT): multicenter pig study on the effect of ischemic preconditioning.

Numerous cardioprotective interventions have been reported to reduce myocardial infarct size (IS) in pre-clinical studies. However, their translation for the benefit of patients with acute myocardial infarction (AMI) has been largely disappointing. One reason for the lack of translation is the lack of rigor and reproducibility in pre-clinical studies.

Lymphatic Regeneration after Popliteal Lymph Node Excision and Implantation of Aligned Nanofibrillar Collagen Scaffolds: An Experimental Rabbit Model.

Lymphedema presents significant challenges to patients' quality of life, prompting the exploration of innovative treatments, such as collagen scaffolds, aimed at treating and reducing the risk of lymphedema. We aimed to evaluate the preventive and therapeutic efficacy and the lymphangiogenic potential of implanted aligned nanofibrillar collagen scaffolds (BioBridge) following the induction of secondary lymphedema in a rabbit model. Thirty rabbits were divided into treatment (G1), prevention (G2), and control (G3) groups.

Optimising Bioprinting Nozzles through Computational Modelling and Design of Experiments.

3D bioprinting is a promising technique for creating artificial tissues and organs. One of the main challenges of bioprinting is cell damage, due to high pressures and tensions. During the biofabrication process, extrusion bioprinting usually results in low cell viability, typically ranging from 40% to 80%, although better printing performance with higher cell viability can be achieved by optimising the experimental design and operating conditions, with nozzle geometry being a key factor.

REVIEW ON COMPLICATIONS AND ADVERSE EFFECTS OF METALLIC URINARY STENTS.

Urinary stents, be it urethral or ureteral, polymeric, metallic or biodegradable, are one of the most frequently used tools in urology and they have been used for decades in prophylactic and therapeutic setting. Although relatively low invasive, they are prone to complications and adverse effects so much that complication rates up to 100% have been described. Many reviews have focused either on specific groups of patients or particular stent types, materials or designs but so far, no comprehensive review on complications has been published.

Applying artificial intelligence on EDA sensor data to predict stress on minimally invasive robotic-assisted surgery.

Purpose: This study aims predicting the stress level based on the ergonomic (kinematic) and physiological (electrodermal activity-EDA, blood pressure and body temperature) parameters of the surgeon from their records collected in the previously immediate situation of a minimally invasive robotic surgery activity.

Methods: For this purpose, data related to the surgeon's ergonomic and physiological parameters were collected during twenty-six robotic-assisted surgical sessions completed by eleven surgeons with different experience levels. Once the dataset was generated, two preprocessing techniques were applied (scaled and normalized), these two datasets were divided into two subsets: with 80% of data for training and cross-validation, and 20% of data for test.

Comparative Study of Ergonomics in Conventional and Robotic-Assisted Laparoscopic Surgery.

Background: This study aims to implement a set of wearable technologies to record and analyze the surgeon's physiological and ergonomic parameters during the performance of conventional and robotic-assisted laparoscopic surgery, comparing the ergonomics and stress levels of surgeons during surgical procedures.

Methods: This study was organized in two different settings: simulator tasks and experimental model surgical procedures. The participating surgeons performed the tasks and surgical procedures in both laparoscopic and robotic-assisted surgery in a randomized fashion.

Lymphatic Patterns in the Superficial Circumflex Iliac Artery Perforator Flap.

Background:  Lymphedema is a chronic condition, characterized by fluid buildup and tissue swelling and is caused by impairment of the lymphatic system. The lymph interpositional flap transfer technique, in which lymph flow is restored with a flap that includes subdermal lymphatic channels, is an option for surgical reconstruction. The superficial circumflex iliac artery perforator (SCIP) flap can be used for this purpose.

Effect of three training programs on surgical performance in single-port laparoscopic surgery.

Objective: The aim of this study was to evaluate the effect of three training methodologies on the acquisition of psychomotor skills for laparoendoscopic single-site surgery (LESS), using straight and articulating instruments.

Methods: A prospective study was conducted with subjects randomly divided into three groups, who performed a specific training for 12 days using three laparoscopic tasks in a laparoscopic simulator. Group-A trained in conventional laparoscopy setting using straight instruments and in LESS setting using both straight and articulating instruments.

Lymphaticovenous anastomosis in rabbits: A novel live experimental animal model for supermicrosurgical training.

Background: Lymphaticovenous anastomosis is widely used in lymphedema management. Although its effectiveness in reducing edema in patients can be clinically observed, evaluating the long-term outcomes of this technique can be complex. This study established an animal model to assess the outcomes of lymphaticovenous anastomosis technique at 15 and 30-days post-surgery using indocyanine green lymphography, Patent Blue V dye injection, and histopathological examination.

Colonic Electrical Stimulation for Chronic Constipation: A Perspective Review.

Chronic constipation affects around 20% of the population and there is no efficient solution. This perspective review explores the potential of colonic electric stimulation (CES) using neural implants and methods of bioelectronic medicine as a therapeutic way to treat chronic constipation. The review covers the neurophysiology of colonic peristaltic function, the pathophysiology of chronic constipation, the technical aspects of CES, including stimulation parameters, electrode placement, and neuromodulation target selection, as well as a comprehensive analysis of various animal models highlighting their advantages and limitations in elucidating the mechanistic insights and translational relevance for CES.

Biopolymers for Tissue Engineering: Crosslinking, Printing Techniques, and Applications.

Currently, tissue engineering has been dedicated to the development of 3D structures through bioprinting techniques that aim to obtain personalized, dynamic, and complex hydrogel 3D structures. Among the different materials used for the fabrication of such structures, proteins and polysaccharides are the main biological compounds (biopolymers) selected for the bioink formulation. These biomaterials obtained from natural sources are commonly compatible with tissues and cells (biocompatibility), friendly with biological digestion processes (biodegradability), and provide specific macromolecular structural and mechanical properties (biomimicry).

Home-based exercise interventions delivered by technology in older adults: A scoping review of technological tools usage.

Despite technology-based systems being considered promising tools to stimulate and increase physical function at home, most older adults are unfamiliar with technology, which may pose some difficulties. Technology-related parameters, such as adherence, acceptance, and acceptability, are crucial to achieving higher efficacy levels of home-based exercise interventions delivered by technology. In this scoping review, we aimed to revise the use of home-based technological tools to improve physical function in the older population, focusing on the user's experience and perspective.

EASIER: A new model for online learning of minimally invasive surgery skills.

Introduction: Technology Enhanced Learning (TEL) can provide the tools to safely master minimally invasive surgery (MIS) skills in patient-free environments and receive immediate objective feedback without the constant presence of an instructor. However, TEL-based systems tend to work isolated from one another, focus on different skills, and fail to provide contents without a sound pedagogical background.

Objective: The objective of this descriptive study is to present in detail EASIER, an innovative TEL platform for surgical and interventional training, as well as the results of its validation.

Benefits of accurate and guided endoureterotomy versus ureteral balloon dilatation in the management of ureteral strictures-comparative animal study.

Background: Endoscopic treatment of ureteral strictures provides a minimally invasive approach with a shorter hospital stay and less postoperative pain. There are different therapeutic options, the dilatation balloon and endoureterotomy with holmium yttrium-aluminum-garnet (Ho:YAG) laser are the most used. To assess histological changes after endoureterotomy in the ureteral stricture treatment comparing Ho:YAG laser endoureterotomy versus balloon dilatation endoureterotomy.

Colchicine added to standard therapy further reduces fibrosis in pigs with myocardial infarction.

Background: The anti-inflammatory drug colchicine improves the outcome of patients with myocardial infarction (MI). As an intense inflammatory and fibrotic response after MI may lead to scar expansion and left ventricular (LV) remodeling, the clinical benefit of colchicine could be related to a positive effect on the infarct scar and LV remodeling.

Methods: Pigs underwent left anterior descending artery occlusion through an angioplasty balloon for 90 min and were then randomized into two groups: standard therapy [ACE inhibitor, beta blocker, mineralocorticoid receptor antagonist (MRA), aspirin] plus colchicine (n = 14) or standard therapy alone (n = 13).

Clinical Validation Benchmark Dataset and Expert Performance Baseline for Colorectal Polyp Localization Methods.

Colorectal cancer is one of the leading death causes worldwide, but, fortunately, early detection highly increases survival rates, with the adenoma detection rate being one surrogate marker for colonoscopy quality. Artificial intelligence and deep learning methods have been applied with great success to improve polyp detection and localization and, therefore, the adenoma detection rate. In this regard, a comparison with clinical experts is required to prove the added value of the systems.

The pathophysiological impact of intra-abdominal hypertension in pigs.

Background: Intra-abdominal hypertension and abdominal compartment syndrome are common with clinically significant consequences. We investigated the pathophysiological effects of raised IAP as part of a more extensive exploratory animal study. The study design included both pneumoperitoneum and mechanical intestinal obstruction models.

Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial.

Technical advances in microsurgery have enabled complex oncological reconstructions by performing free tissue transfers, nerve and lymphatic reconstructions. However, the manual abilities required to perform microsurgery can be affected by human fatigue and physiological tremor resulting in tissue damage and compromised outcomes. Robotic assistance has the potential to overcome issues of manual microsurgery by improving clinical value and anastomoses' outcomes.