Surgical innovation
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Surgical innovation · Feb 2021
ReviewAdaptations and Safety Modifications to Perform Safe Minimal Access Surgery (Minimally Invasive Surgery: Laparoscopy and Robotic) during the COVID-19 Pandemic.
It is inevitable that some patients with suspected or confirmed COVID-19 may require urgent surgical procedures. The objective of this review was to discuss the modifications required in the operating room during COVID-19 times for minimal access, laparoscopy, and robotic surgery, especially with regard to minimally invasive surgical instruments, buffalo filter, trocars with smoke evacuator, and special personal protection equipment. We have discussed the safety measures to be followed for the suspected or confirmed COVID-19 patient. ⋯ Although there is little evidence of viral transmission through laparoscopic or open approaches, we recommend modifications to surgical practice such as the use of safe smoke evacuation and minimizing energy device use to reduce the risk of exposure to aerosolized particles to the health care team. Therefore, hospitals must follow specific protocols and arrange suitable training of the health care workers. Following well-established plans to accomplish un-deferrable surgeries in COVID-19-positive patients is strongly recommended.
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Surgical innovation · Apr 2020
ReviewAn Interdisciplinary Review of Surgical Data Recording Technology Features and Legal Considerations.
Surgical data recording technology has great promise to generate patient safety and quality data that can be utilized to potentially reduce medical errors. Variations of these systems aim to improve surgical technique, develop better training simulation, and promote adverse event investigation similar to the aims of black box technology utilized in other industries. However, many unknowns remain for surgical data recording utilization in operating rooms and clinical settings in the United States. ⋯ We found technology ranging from audio and visual data, to systems utilizing mobile applications, and kinematic data capture. The data collected present legal questions over ownership of information and privacy, along with regulatory issues at the federal and state levels. The benefits of these data should be balanced with the need to develop appropriate policies and regulations that protect the interests of both clinicians and patients in order to encourage further innovation and better realize the potential of surgical data recording technology to improve clinical decision making and patient safety outcomes.
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Surgical innovation · Aug 2014
ReviewSurgical smartphone applications across different platforms: their evolution, uses, and users.
There are a vast array of smartphone applications that could benefit both surgeons and their patients. To review and identify all relevant surgical smartphone applications available for the Apple iPhone iOS and Google Android platform based on their user group and subspecialty for which they were designed. ⋯ Despite the plethora of surgical applications available for smartphones, there is no taxonomy for medical applications. Only 12% were affiliated with an academic institution or association, which highlights the need for greater regulation of surgical applications.
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Recent advances in adipose cellular biology have repopularized autologous fat grafting as a method widely used in both reconstructive and aesthetic surgery. This review aims to summarize our current knowledge on autologous fat grafting emphasizing harvesting techniques and processing methods as well as current trends and approaches. ⋯ Further in-depth knowledge will provide definite answers on fat graft survival; demonstrate safe methods to increase cell viability, grafting outcome predictability; and reliability; enhance safety; and strengthen the scientific and clinical establishment of this increasingly promising method.
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Surgical innovation · Feb 2014
ReviewThe role of intraoperative nerve monitoring (IONM) in thyroidectomy: where do we stand today?
Intraoperative nerve monitoring (IONM) gains daily ground, being used during thyroidectomy to help the surgeon identify the recurrent laryngeal nerve (RLN). But its value still remains debatable among endocrine surgeons. In this review article, we aim to present current knowledge on the subject. ⋯ RLN IONM adds a functional dimension to surgery that aids, but does not replace, visual identification. For the time being, intraoperative visual identification of the nerve and preoperative and postoperative laryngoscopic assessment of vocal cord function remain the gold standard of RLN management in thyroid surgery. Whether IONM will become a standard of care or not depends on the familiarization of each surgeon with this technique as well as on the publication of studies involving large series of thyroidectomies, where the evaluation of IONM will have significant statistical power.