Surgical innovation

外科创新
  • 文章类型: Journal Article
    现有的报告指南对手术技术的详细和全面报告重视不够。外科技术报告清单和标准(SUPER)旨在通过定义外科技术的报告标准来解决这一差距。SUPER指南旨在适用于任何研究设计中包含手术技术的文章,外科学科,和外科创新阶段。
    遵循EQUATOR(增强卫生研究的质量和透明度)网络方法,16位外科医生,期刊编辑,方法学家审查了与手术技术有关的现有报告指南,审查了15种顶级期刊的论文,集思广益,为SUPER起草初始项目。最初的项目是通过来自13个国家和地区的21名多学科德尔福小组专家进行的三轮德尔福调查进行的。最终的SUPER项目是在在线共识会议之后形成的,该会议旨在解决所有16名SUPER工作组成员和5名SUPER顾问的三轮措辞完善。
    SUPER报告指南包括22个项目,这些项目被认为对于良好和信息丰富的外科技术报告至关重要。项目分为六个部分:背景,理由,术前准备和要求(第6至9项);手术技术细节(第10至15项);术后考虑和任务(第16至19项);总结和展望(第20和21项);和其他信息(第22项)。
    SUPER报告指南有可能指导详细的,全面,和外科医生透明的手术技术报告。它也可以帮助期刊编辑,同行审稿人,系统审稿人,并指导开发人员评估手术技术文件,并帮助从业者更好地理解和再现手术技术。
    https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/#SUPER.
    UNASSIGNED: Existing reporting guidelines pay insufficient attention to the detail and comprehensiveness reporting of surgical technique. The Surgical techniqUe rePorting chEcklist and standaRds (SUPER) aims to address this gap by defining reporting standards for surgical technique. The SUPER guideline intends to apply to articles that encompass surgical technique in any study design, surgical discipline, and stage of surgical innovation.
    UNASSIGNED: Following the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network approach, 16 surgeons, journal editors, and methodologists reviewed existing reporting guidelines relating to surgical technique, reviewed papers from 15 top journals, and brainstormed to draft initial items for the SUPER. The initial items were revised through a three-round Delphi survey from 21 multidisciplinary Delphi panel experts from 13 countries and regions. The final SUPER items were formed after an online consensus meeting to resolve disagreements and a three-round wording refinement by all 16 SUPER working group members and five SUPER consultants.
    UNASSIGNED: The SUPER reporting guideline includes 22 items that are considered essential for good and informative surgical technique reporting. The items are divided into six sections: background, rationale, and objectives (items 1 to 5); preoperative preparations and requirements (items 6 to 9); surgical technique details (items 10 to 15); postoperative considerations and tasks (items 16 to 19); summary and prospect (items 20 and 21); and other information (item 22).
    UNASSIGNED: The SUPER reporting guideline has the potential to guide detailed, comprehensive, and transparent surgical technique reporting for surgeons. It may also assist journal editors, peer reviewers, systematic reviewers, and guideline developers in the evaluation of surgical technique papers and help practitioners to better understand and reproduce surgical technique.
    UNASSIGNED: https://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-other-study-designs/#SUPER.
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  • 文章类型: Journal Article
    During video-assisted thoracic surgery, surgical smoke can interfere with surgeons\' vision and attention. In addition, the harmful substances in the surgical smoke also threaten the health of surgical staff. In practice, we designed an economical and available solution for the smoke in video-assisted thoracic surgery and got satisfactory results. This paper introduces the principle and procedure of this solution.
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  • 文章类型: Journal Article
    未经评估:一项回顾性研究。
    UNASSIGNED:本研究旨在评估桥式起重机技术与椎板切除术治疗黄韧带骨化(OLF)引起的胸脊髓病的安全性和有效性。
    UNASSIGNED:本研究纳入了我院2017年5月至2018年6月因胸部OLF而接受手术减压的41例患者,并分为BG组(桥式起重机技术,n=19)和L组(椎板切除术,n=22)。从医疗记录中收集人口统计学数据,并使用改良的日本骨科协会(JOA)评分系统来评估随访期间的神经系统结局。对手术相关并发症进行分析。
    UNASSIGNED:BG组(19.4±1.5个月)和L组(19.6±1.4个月)的平均随访时间相当。两组在性别方面无统计学差异,年龄,症状持续时间,术前占位率,参与水平,操作时间,术中失血,和并发症。两组的JOA评分在最后一次随访时显著增加。然而,BG组患者的JOA评分和恢复率较高(P<0.05)。L组4例患者出现并发症,其中脑脊液(CSF)漏3例,术后血肿1例。BG组中只有1例患者出现CSF渗漏。
    UNASSIGNED:这项研究的结果表明,桥式起重机技术对于有症状的胸部OLF患者可能相对安全有效,具有更令人满意的临床改善。然而,仍需要高质量的研究来验证本研究的结果.
    UNASSIGNED: A retrospective study.
    UNASSIGNED: This study aimed to evaluate the safety and effectiveness of the bridge crane technique versus laminectomy for the treatment of thoracic myelopathy caused by ossification of the ligamentum flavum (OLF).
    UNASSIGNED: Totally 41 patients who underwent surgical decompression due to thoracic OLF from May 2017 to June 2018 in our institution were enrolled in this study and were divided into group BG (bridge crane technique, n = 19) and group L (laminoectomy, n = 22). Demographic data was collected from medical records and the modified Japanese Orthopaedic Association (JOA) scoring system was used to evaluate the neurological outcomes during the follow-up. Surgery-related complications were analyzed.
    UNASSIGNED: The mean duration of follow-up was comparable between group BG (19.4 ± 1.5 months) and group L (19.6 ± 1.4 months). No statistical differences were observed between two groups in terms of gender, age, duration of symptoms, preoperative occupying rate, involved levels, operation time, intraoperative blood loss, and complications. The JOA score significantly increased at the final follow-up in both groups. However, patients in group BG had higher JOA score and recovery rate (P < 0.05). Four patients in group L experienced complications, including 3 cerebrospinal fluid (CSF) leakage and one postoperative hematoma. Only one patient in group BG had CSF leakage.
    UNASSIGNED: The results of this study suggested that bridge crane technique may be relatively safe and effective for patients with symptomatic thoracic OLF with more satisfactory clinical improvement. However, high-quality studies are still required to validate the results of this study.
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  • 文章类型: Journal Article
    Surgery for rectal cancer has obtained quick improvement in techniques and concepts in recent years but still has challenging areas. Colorectal surgeons always seek to make operations clearer and easier, so that surgery can be safer and less time-consuming while guaranteeing surgical goals. With this purpose, our team have explored to make innovations in operations for rectal cancer and translate relevant patents from 2009. We summarize our achievements in this article as follows: (1) Reverse Miles operation (perineal operation first then laparoscopic abdominal operation) with two relevant patents-specialized instruments bag for laparoscopic operations (patent number ZL201520442331.0) and accessory spotlight for ultrasound scalpel (patent number ZL20102 0137689.X). (2) Laparoscopic sphincter-saving surgery for low rectal cancer through marker meeting approach with two patents-vacuum rectal drainage tube with functions of irrigation and ventilation (patent number ZL201520374385.8) and sterile sleeve cover of ultrasound scalpel handle (patent number ZL201920648102.2). (3) Laparoscopic radical resection of colorectal cancer and natural orifice specimen extraction. Different methods were designed according to the location of the tumor that classified as 20-40 cm, 10-20 cm and 5-10 cm to anus. Two relevant patents were specialized instruments for natural orifice specimen extraction (patent application number ZL2017101480141) and plastic film sleeve for natural orifice specimen extraction (patent application number ZL 201921169857.0). Reformation of surgical technique and innovation of surgical instruments should be conducted by surgeons with innovative thinking who always seek the way to translate ideas to patents and then real products to promote surgical treatment.
    直肠癌外科治疗的技术和理念近年来发展迅速,但仍存在一些难点。在保证手术目标的基础上,通过创新和改良,使困难手术变得清晰、简便,从而缩短手术时间,降低风险,是结直肠外科医生追求的目标。本团队自2009年以来,针对直肠癌手术的难点,尝试进行术式改进和相关专利转化,具体包括:(1)逆行Miles手术(先行会阴部手术,再行腹腔镜手术)及相关专利[腹腔镜手术器械袋(专利号ZL201520442331.0)、超声刀辅助光源(专利号ZL20102 0137689.X)]。(2)经上下入路会师的低位直肠癌保肛根治术及相关专利[直肠冲水通气负压引流管(专利号ZL20152 0374385.8)、超声刀柄无菌连接套(专利号ZL20192 0648102.2)]。(3)经自然腔道取标本腹腔镜结直肠癌根治术(针对肿瘤距肛门20~40 cm、10~20 cm和5~10 cm进行分类处理)及相关专利[经自然腔道取标本装置(专利申请号ZL 2017101480141)、经自然腔道取标本薄膜套(专利申请号ZL 201921169857.0)]。外科医生是手术方式改进和手术器械创新的主角,应在实际工作中积极思考、勇于创新、总结成果、寻求转化,从而推动外科治疗的前进。.
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  • 文章类型: Journal Article
    BACKGROUND: The incidence of biliary complications after living donor adult liver transplantation (LDALT) is still high due to the bile duct variation and necessity reconstruction of multiple small bile ducts. The current surgical management of the biliary variants is unsatisfactory. We evaluated the role of a new surgical approach in a complicated hilar bile duct variant (Nakamura type IV and Nakamura type II) under emergent right lobe LDALT for high model for end-stage liver disease score patients.
    METHODS: The common hepatic duct (CHD) and the left hepatic duct (LHD) of the donor were transected in a right-graft including short common trunks with right posterior and anterior bile ducts, whereas the LHD of the donor was anastomosed to the CHD and the common trunks of a right-graft bile duct and the recipient CHD was end-to-end anastomosed.
    RESULTS: Ten of 13 grafts (Nakamura types II, III, and IV) had two or more biliary orifices after right graft lobectomy; seven patients had biliary complications (53.8%). Later, the surgical innovation was carried out in five donors with variant bile duct (four Nakamura type IV and one type II), and, consequently, no biliary or other complications were observed in donors and recipients during 47-53 months of follow-up; significant differences (P < 0.05) were found when two stages were compared.
    CONCLUSIONS: Our initial experience suggests that, in the urgent condition of LDALT when an alternative live donor was unavailable, a surgical innovation of cutting part of the CHD trunks including variant right hepatic ducts in a complicated donor bile duct variant may facilitate biliary reconstruction and reduce long-term biliary complications.
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