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Topic Review
Surgery in Autoimmune Pancreatitis
Autoimmune pancreatitis (AIP) was first described as a clinical entity in 1961 by Sarles et al. who described a type of sclerosing pancreatitis associated with hypergammaglobulinemia.
  • 305
  • 06 Feb 2023
Topic Review
Thymus Surgery in Myasthenia Gravis
The thymus is a lymphoid organ involved in the differentiation of T cells, and has a central role in the physiopathogenesis of Myasthenia Gravis (MG). This connection is proved by a series of changes in the level of neuromuscular junctions, which leads to a decrease in the amplitude of the action potential in the post-synaptic membrane. Because of this, the presence of anti-cholinergic receptor antibodies (AChR), characteristic of MG, is found, which causes the progressive regression of the effect of acetylcholine at the level of neuromuscular junctions, with the appearance of muscle weakness. The thymectomy is a surgical variant of drug therapy administered to patients with MG. In the case of patients with nonthymomatous MG, thymectomy has become a therapeutic standard, despite the fact that there is no solid scientific evidence to explain its positive effect. Videothoracoscopic surgery or robotic surgery led to a decrease in the length of hospital stay for these patients.
  • 304
  • 08 Mar 2024
Topic Review
Historical Development of Durable Ventricular Assist Devices
Heart transplantation is  the most effective treatment for end-stage heart failure; however, the shortage in donor hearts constrains the undertaking of transplantation. Mechanical circulatory support (MCS) technology has made rapid progress, providing diverse therapeutic options and alleviating the dilemma of donor heart shortage. The ventricular assist device (VAD), as an important category of MCS, demonstrates promising applications in bridging heart transplantation, destination therapy, and bridge-to-decision. VADs can be categorized as durable VADs (dVADs) and temporary VADs (tVADs), according to the duration of assistance. With the technological advancement and clinical application experience accumulated, VADs have been developed in biocompatible, lightweight, bionic, and intelligent ways.
  • 302
  • 17 Feb 2024
Topic Review
Venous Thromboembolisms (VTEs) in Total Knee Arthroplasty (TKA)
The entry provides a comprehensive overview of Venous Thromboembolisms (VTEs) in Total Knee Arthroplasty (TKA), a significant orthopedic procedure. It begins by highlighting the persistent threat of VTEs despite improvements in surgical techniques and preventive measures. The prevalence and incidence of VTEs are discussed, showcasing a notable decrease over the years. The clinical significance of VTEs, including their impact on patient outcomes and healthcare costs, is emphasized, underscoring the need for effective management strategies. Various risk factors contributing to VTE development post-TKA are explored, including demographic factors, cardiopulmonary status, preoperative mobilization status, and malignancy. The section on prevention outlines existing guidelines and challenges, with a focus on the efficacy and safety of aspirin as a prophylactic agent. Finally, the conclusion emphasizes the importance of a comprehensive approach to address VTEs in TKA, encompassing evidence-based guidelines, personalized patient care, and strategies to enhance adherence to preventive measures.
  • 302
  • 30 Apr 2024
Topic Review
History of Preoperative Planning for Breast Reconstruction
Breast reconstruction is an essential component in the multidisciplinary management of breast cancer patients. Over the years, preoperative planning has played a pivotal role in assisting surgeons in planning operative decisions prior to the day of surgery. The evolution of preoperative planning can be traced back to the introduction of modalities such as ultrasound and colour duplex ultrasonography, enabling surgeons to evaluate the donor site’s vasculature and thereby plan operations more accurately. However, the limitations of these techniques paved the way for the implementation of modern three-dimensional imaging technologies. With the advancements in 3D imaging, including computed tomography and magnetic resonance imaging, surgeons gained the ability to obtain detailed anatomical information. Moreover, numerous adjuncts have been developed to aid in the planning process. The integration of 3D-printing technologies has made significant contributions, enabling surgeons to create complex haptic models of the underlying anatomy. Direct infrared thermography provides a non-invasive, visual assessment of abdominal wall vascular physiology. Additionally, augmented reality technologies are poised to reshape surgical planning by providing an immersive and interactive environment for surgeons to visualize and manipulate 3D reconstructions. Still, the future of preoperative planning in breast reconstruction holds immense promise. 
  • 299
  • 17 Aug 2023
Topic Review
Surgical Antibiotic Prophylaxis
In the multimodal strategy context, to implement healthcare-associated infection prevention, bundles are one of the most commonly used methods to adapt guidelines in the local context and transfer best practices into routine clinical care. One of the most important measures to prevent surgical site infections is surgical antibiotic prophylaxis (SAP).
  • 298
  • 02 Feb 2024
Topic Review
Technological Synergies in Cranial Base Surgery
The genesis of Anterior Skull Base (ASB) surgery as a distinct field is anchored in the innovations of the 1940s. Dandy’s instrumental contributions are emblematic of this era, particularly his surgical strategy via the anterior cranial fossa for the excision of orbital tumors and his subsequent expansion of the resection to incorporate the ethmoidal regions.
  • 294
  • 01 Nov 2023
Topic Review
Intraoperative Imaging in Hepatopancreatobiliary Surgery
Hepatopancreatobiliary surgery belongs to one of the most complex fields of general surgery. An intricate and vital anatomy is accompanied by difficult distinctions of tumors from fibrosis and inflammation; the identification of precise tumor margins; or small, even disappearing, lesions on currently available imaging. The routine implementation of ultrasound use shifted the possibilities in the operating room, yet more precision is necessary to achieve negative resection margins. Modalities utilizing fluorescent-compatible dyes have proven their role in hepatopancreatobiliary surgery, although this is not yet a routine practice, as there are many limitations. Modalities, such as photoacoustic imaging or 3D holograms, are emerging but are mostly limited to preclinical settings. There is a need to identify and develop an ideal contrast agent capable of differentiating between malignant and benign tissue and to report on the prognostic benefits of implemented intraoperative imaging in order to navigate clinical translation.
  • 287
  • 23 Oct 2023
Topic Review
Nano/Micromotors Based on Microbers
The bio-hybrid micro-nano motors/robots (BMNRs) use a variety of biological carriers, blending the benefits of artificial materials with the unique features of different biological carriers to create tailored functions for specific needs. Compared to cell-based MNRs, microbe-carrier micro-nano robots (MNRs) have very many unique properties. In contrast to most cell-based motors that require active actuation, the most important feature of microbe-based motors is their sensing and self-driving capabilities. Especially, they have good performance in the face of low Reynolds number environments. This is due in large part to the transverse wave that they generate during their movements. This property of converting chemical energy into flagellar-driven mechanical energy allows microbial-based MNRs to be designed with only the manipulation in mind and without the need to provide an additional power source. The most commonly used microbial-based MNRs today include bacterial and algal carriers.
  • 284
  • 19 May 2023
Topic Review
Inflatable Video-Assisted Mediastinoscopic Transhiatal Esophagectomy of Esophageal Cancer
Inflatable video-assisted mediastinoscopic transhiatal esophagectomy (IVMTE) has emerged as a promising treatment option for esophageal cancer because it does not require one-lung ventilation, reduces postoperative complications, and expands surgical indications. This technique also provides surgical opportunities for patients with impaired pulmonary function or thoracic lesions.
  • 277
  • 01 Nov 2023
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