1,721,050 research outputs found
Evaluation of current and emerging endoluminal robotic platforms using the IDEAL framework.
Full text link� 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.Background: Robotic-assisted endoluminal systems are rapidly evolving within the field of minimally invasive surgery. The IDEAL framework (Idea, Development, Exploration, Assessment, and Surveillance) can be used to evaluate novel technologies. This review provides a summary of current and emerging endoluminal systems using the IDEAL framework.
Methods: A scoping review was conducted to include all existing and developing robotic-assisted endoluminal systems. Data was collected via virtual interviews, questionnaires, biomedical databases, company websites, and peer-reviewed articles. Key metrics were reported, enabling the assignment of each system to an IDEAL stage.
Results: The review identified 17 distinct systems from 16 companies. Nine systems received regulatory approval in their respective countries. Our evaluation showed that two systems were at the pre-IDEAL Stage 0. Seven systems were in the Idea stage (Stage 1), six systems were in the Development stage (Stage 2) and two systems completed Stage 3. No system underwent long-term study evaluation (Stage 4).
Conclusions: There is a gap in long-term clinical data of robotic-assisted endoluminal systems, indicated by the absence of systems at Stage 4. Collaborative efforts amongst the medical community, regulatory bodies, and industry specialists are vital to ensure the delivery of evidence-based medicine in the discipline of robotics
Assessment and application of non-technical skills in robotic-assisted surgery: a systematic review.
No full textOpen Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Background: Undeniably, robotic-assisted surgery (RAS) has become very popular in recent decades, but it has introduced challenges to the workflow of the surgical team. Non-technical skills (NTS) have received less emphasis than technical skills in training and assessment. The systematic review aimed to update the evidence on the role of NTS in robotic surgery, specifically focusing on evaluating assessment tools and their utilisation in training and surgical education in robotic surgery.
Methods: A systematic literature search of PubMed, PsycINFO, MEDLINE, and EMBASE was conducted to identify primary articles on NTS in RAS. Messick's validity framework and the Modified Medical Education Research Study Quality Instrument were utilised to evaluate the quality of the validity evidence of the abstracted articles.
Results: Seventeen studies were eligible for the final analysis. Communication, environmental factors, anticipation and teamwork were key NTS for RAS. Team-related factors such as ambient noise and chatter, inconveniences due to repeated requests during the procedure and constraints due to poor design of the operating room may harm patient safety during RAS. Three novel rater-based scoring systems and one sensor-based method for assessing NTS in RAS were identified. Anticipation by the team to predict and execute the next move before an explicit verbal command improved the surgeon's situational awareness.
Conclusion: This systematic review highlighted the paucity of reporting on non-technical skills in robotic surgery with only three bespoke objective assessment tools being identified. Communication, environmental factors, anticipation, and teamwork are the key non-technical skills reported in robotic surgery, and further research is required to investigate their benefits to improve patient safety during robotic surgery
Laparoscopic and robotic surgery for colorectal cancer in older patients: a systematic review and meta-analysis.
No full textIntroduction: As life expectancy has been increasing, older patients are becoming more central to the healthcare system, leading to more intensive care use and longer hospital stays. Nevertheless, advancements in minimally invasive surgical techniques offer safe and effective options for older patients with colorectal diseases. This study aims to provide comprehensive evidence on the role of minimally invasive surgery in treating colorectal diseases in older patients. Material and methods: All articles directly compared the minimally invasive approach with open surgery in patients aged ≥65 years. The present metanalysis took 30-day complications as primary outcomes. Length of hospital stay, readmission, and 30-day mortality were also assessed, as secondary outcomes. Further subgroup analyses were carried out based on surgery setting, lesion features, and location. Results: After searching the main databases, 84 articles were included. Evaluation of 30-day complications rate, length of hospital stay, and 30-day mortality significantly favored minimally invasive approaches. The outcome readmission did not show any significant difference. Conclusions: The current metanalysis demonstrates clear advantages of minimally invasive techniques over open surgery in colorectal procedures for older patients, particularly in reducing complications, mortality, and hospitalization. This suggests that prioritizing these techniques, based on available expertise and facilities, could improve outcomes and quality of care for older patients undergoing colorectal surgery
Objective assessment tools in laparoscopic or robotic-assisted gynecological surgery: A systematic review.
No full textThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution inany medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.© 2024 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetricsand Gynecology (NFOG)Introduction: There is a growing emphasis on proficiency-based progression within surgical training. To enable this, clearly defined metrics for those newly acquired surgical skills are needed. These can be formulated in objective assessment tools. The aim of the present study was to systematically review the literature reporting on available tools for objective assessment of minimally invasive gynecological surgery (simulated) performance and evaluate their reliability and validity.
Material and methods: A systematic search (1989-2022) was conducted in MEDLINE, Embase, PubMed, Web of Science in accordance with PRISMA. The trial was registered with the Prospective Register of Systematic Reviews (PROSPERO) ID: CRD42022376552. Randomized controlled trials, prospective comparative studies, prospective single-group (with pre- and post-training assessment) or consensus studies that reported on the development, validation or usage of assessment tools of surgical performance in minimally invasive gynecological surgery, were included. Three independent assessors assessed study setting and validity evidence according to a contemporary framework of validity, which was adapted from Messick's validity framework. Methodological quality of included studies was assessed using the modified medical education research study quality instrument (MERSQI) checklist. Heterogeneity in data reporting on types of tools, data collection, study design, definition of expertise (novice vs. experts) and statistical values prevented a meaningful meta-analysis.
Results: A total of 19 746 titles and abstracts were screened of which 72 articles met the inclusion criteria. A total of 37 different assessment tools were identified of which 13 represented manual global assessment tools, 13 manual procedure-specific assessment tools and 11 automated performance metrices. Only two tools showed substantive evidence of validity. Reliability and validity per tool were provided. No assessment tools showed direct correlation between tool scores and patient related outcomes.
Conclusions: Existing objective assessment tools lack evidence on predicting patient outcomes and suffer from limitations in transferability outside of the research environment, particularly for automated performance metrics. Future research should prioritize filling these gaps while integrating advanced technologies like kinematic data and AI for robust, objective surgical skill assessment within gynecological advanced surgical training programs
Exhaled volatile organic compounds in the detection of colorectal cancer: a systematic review and meta-analysis.
Full text linkCopyright (c) 2024 Daniah Alsaadi, Nicolle Clements, Natiya Gabuniya, Nader Francis, Manish Chand
This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0/).There is an apparent need for novel non-invasive colorectal cancer (CRC) screening tests that are more acceptable to patients and can reliably detect CRC or reduce the number of unnecessary colonoscopies performed in cancer-free patients. An emerging number of studies demonstrate the potential value of exhaled volatile organic compounds (VOCs) as a diagnostic and triaging test for CRC. A systematic appraisal and meta-analysis of the published evidence was done to determine whether exhaled VOCs can be used in the detection and screening of CRC. Nine electronic databases were searched from inception of the databases until August 2020. Quantitative and descriptive data of CRC patients and healthy control (HC) participants who underwent VOCs breath analysis was extracted. In addition, where possible, sampling methods, analytical platforms, processors, and specific breath biomarkers found in each study were recorded. Fourteen articles were included in the systematic review with 491 colorectal patients and 754 HC participants (n=1245). Sub-group meta-analysis was conducted on nine of those articles and the pooled sensitivity was estimated to be 0.89 (95 % CI = 0.80-0.99) whereas specificity was 0.83 (95 % CI = 0.74-0.92). Heterogeneity of pooled sensitivity and specificity was estimated as I=11.11 %. Although this study was limited by small sample size and different analytical platforms, the proposed future framework resolves such limitations and standardizes future research. It is reasonable to deduce that VOCs breath analysis is certainly a field of research that can progress to replace traditional methods within the framework of CRC screening and diagnosis
Fellowship of the European Board of Surgery in the specialty of Minimally Invasive Surgery (FEBS/MIS): a continuous evaluation
No full textBackgroundMinimally Invasive Surgery (MIS) has become the standard approach for many procedures, driving rapid changes in training pathways and challenging traditional assessment and accreditation methods. To address this, the European Union of Medical Specialists (UEMS), in collaboration with the European Association for Endoscopic Surgery (EAES), established a working group in 2015 to develop a MIS-specific board fellowship exam (Fellow of European Board of Surgery in Minimally Invasive Surgery (F.E.B.S./MIS)). This rigorous, multi-modality examination assesses surgeons' knowledge and skills to ensure high-quality independent practice. This study provides an overview of the exam's development, structure, and quality assurance, with a focus on participant evaluation.MethodsEligibility followed UEMS criteria, including certified MIS training, case logbook documentation, and English proficiency. The exam comprised a 100-item multiple-choice test (MCQ) and an objective structured clinical examination (OSCE) with clinical scenarios and validated technical skill tasks. Participants completed evaluation questionnaires on exam experience. Data were analyzed using descriptive statistics, linear regression, and independent-samples t-tests to examine associations between experience, performance, and total scores.ResultsBetween 2018 and 2024, 119 participants from 28 countries undertook the exam in seven European countries. Most were experienced attending surgeons, with pass rates of 61-88%. Higher credit scores were linked to passing, though not directly correlated, indicating experience alone did not ensure success. Fellowships were considered as the optimal exam time, with motivations including certification and knowledge updates. Feedback was highly positive, especially for oral case-based stations, and nearly all recommended the exam. Suggested improvements included streamlining the application process, enhancing practical training opportunities, offering flexible dates, and enabling exams in candidates' home countries or languages.ConclusionThe UEMS/EAES MIS Board exam is firmly established as a specialized certification for MIS and has been well received by participants. Nevertheless, its broader influence and professional recognition still require systematic assessment.Funding Agencies|Pavol Jozef Scaron;afrik University in Koscaron;ice; European Association for Endoscopic Surgery (EAES); KG (Tuttlingen, Germany)</p
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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