We mainly use the d-invariant surgery formula established by Wu and Yang \cite{wu2025surgerieslensspacestype} to study the distance one surgeries along a homologically essential knot between lens spaces of the form $L(p,1)$ and $L(q,2)$ where $p,q$ are odd integers.
Ninad Kishor Honwadkar, Eknath Deosing Pawar, Abhiram T V
et al.
Introduction:
Osteochondromas (OCs) are benign hamartomatous lesions composed of cartilage and bone, arising from aberrant growth-plate cartilage. They characteristically project from the bone surface through the cortex and grow by endochondral ossification beneath the periosteum. Lesion growth usually parallels skeletal growth and typically ceases after physeal closure, although minimal growth of the cartilage cap may persist and generally stops by the third decade of life.
This developmental mechanism explains the predilection for involvement of the distal femur, proximal tibia, and proximal humerus. Most OCs are asymptomatic and do not require surgical intervention. However, intra-articular or atypically located lesions may produce pain, restricted joint movement, or compression of adjacent neurovascular structures, necessitating operative management.
Case Report:
A 39-year-old male presented to the outpatient department with complaints of left-sided hip pain associated with restricted range of motion and radiating pain along the posterior aspect of the left thigh, accompanied by buttock pain for 6 months. The symptoms had gradually progressed and were aggravated by activity. The patient also reported mild paresthesia over the anteromedial aspect of the left knee and the dorsum of the left foot. He noticed a gradually enlarging, ill-defined mass in the left gluteal region during the same period.
On clinical examination, a firm, immobile mass measuring approximately 10 × 6 cm was palpated in the left buttock. Left hip flexion was limited to 60° due to pain. Neurological examination revealed weakness of both plantar flexion and dorsiflexion of the left ankle.
The patient had previously received conservative treatment, including rest, non-steroidal anti-inflammatory drugs, and physiotherapy at another institution, with no improvement in symptoms.
Results:
The lesion was excised through a posterior approach with the patient positioned in the right lateral decubitus position, as described by Yu et al. The sciatic nerve was identified, carefully dissected, and protected throughout the procedure. The OCs were excised using an osteotome. Intraoperative assessment of the femoral neck revealed no cortical defects or fractures, and no fixation was required. Histopathological examination confirmed the diagnosis of OCs with a cartilaginous cap measuring <1 cm.
Conclusion:
Sciatic nerve compression symptoms in non-traumatic cases in young adults may result due to intra or extraspinal causes, depending on the anatomical site of involvement. Lumbar intervertebral disc prolapse and spinal canal stenosis constitute the most frequent intraspinal causes. Extraspinal etiologies are comparatively rare and include conditions such as piriformis syndrome and pelvic bone lesions. Benign bone tumors, particularly OCs, though uncommon, should be considered as a potential source of sciatic nerve compression. OCs arising from the femoral neck with intra-articular or posterior extension are rare, particularly in adults, and may present with pain, mechanical restriction of movement, and neurological symptoms due to mass effect. Awareness of such atypical presentations is essential to avoid misdiagnosis and delays in appropriate management.
Orthopedic surgery, Diseases of the musculoskeletal system
Daniel Becker, MD, Ahmed Ali, MD, Anja Lehmann, MD
et al.
Objective: Juxtarenal abdominal aortic aneurysms (AAAs), pose a greater surgical challenge than infrarenal AAAs and often require suprarenal aortic clamping during open repair. This study aims to assess the impact of suprarenal vs infrarenal clamping on short- and long-term renal outcomes, mortality, and reintervention rates. Methods: A retrospective cohort analysis was conducted on 1250 patients undergoing open AAA repair between 2000 and 2020 at a tertiary vascular center. Patients were stratified into suprarenal and infrarenal clamping groups. Outcomes included 30-day mortality, major adverse events, acute kidney injury, new-onset dialysis, chronic kidney disease (CKD), long-term mortality, and reintervention. Propensity score matching and multivariate analysis were used to adjust for confounders. Results: Of the cohort, 492 underwent suprarenal and 758 infrarenal clamping. The suprarenal group experienced higher 30-day major adverse events (20.9% vs 16.2%; P = .036), acute kidney injury (37.6% vs 22.0%; P < .001), and new-onset dialysis (4.5% vs 1.8%; P = .009). At a median follow-up of 8.6 years, CKD incidence was significantly higher in the suprarenal group (28.5% vs 21.1%; P = .004), as was all-cause mortality (41.3% vs 32.4%; P < .001). We found no difference in reintervention rates between groups. In the propensity-matched cohort, CKD remained significantly more common with suprarenal clamping (P < .001), whereas differences in mortality were not statistically significant. Conclusions: Suprarenal clamping during open AAA repair is associated with increased postoperative renal complications and long-term CKD and mortality, despite similar reintervention and short-term mortality rates. These findings support the need for individualized surgical planning.
Diseases of the circulatory (Cardiovascular) system, Surgery
Advances in computer vision, particularly in optical image-based 3D reconstruction and feature matching, enable applications like marker-less surgical navigation and digitization of surgery. However, their development is hindered by a lack of suitable datasets with 3D ground truth. This work explores an approach to generating realistic and accurate ex vivo datasets tailored for 3D reconstruction and feature matching in open orthopedic surgery. A set of posed images and an accurately registered ground truth surface mesh of the scene are required to develop vision-based 3D reconstruction and matching methods suitable for surgery. We propose a framework consisting of three core steps and compare different methods for each step: 3D scanning, calibration of viewpoints for a set of high-resolution RGB images, and an optical-based method for scene registration. We evaluate each step of this framework on an ex vivo scoliosis surgery using a pig spine, conducted under real operating room conditions. A mean 3D Euclidean error of 0.35 mm is achieved with respect to the 3D ground truth. The proposed method results in submillimeter accurate 3D ground truths and surgical images with a spatial resolution of 0.1 mm. This opens the door to acquiring future surgical datasets for high-precision applications.
PurposeTo guide the drug selection for treatment of moderate to severe ulcerative colitis (UC) by evaluating the efficacy and safety of various drugs.MethodsThis systematic review searched the Embase, PubMed, The Cochrane Library, and Web of Science databases and included randomized controlled trials (RCTs) based on the drugs used alone or in combination for treating UC. Moreover, the Stata17.0 software was employed for statistical analysis and results were reported as relative risk (RR) and 95% confidence interval (CI).ResultsFor the efficacy of induction, upadacitinib ranked first in clinical response, clinical remission, and endoscopic improvement rates, with cumulative probabilities of 96.0%, 99.3%, and 99.0%, respectively. Moreover, for the efficacy of maintenance, upadacitinib ranked first in both clinical remission and endoscopic improvement with a cumulative probability of 93.2% and 93.3%, respectively. For safety, vedolizumab showed the best incidence of adverse events (AE) with 16.8% cumulative probability, while upadacitinib showed the best incidence of serious adverse events (SAE) with 13.8% cumulative probability.ConclusionIn a systematic review and network meta-analysis, we found upadacitinib showed the best efficacy and safety in to be ranked highest in patients with moderate to severe ulcerative colitis. More trials of direct comparisons are needed to inform clinical decision making with greater confidence.
Bearing in mind the expression, “<i>The art challenges the technology, and the technology inspires the art</i>”, we say that oral surgery is changing rapidly due to the introduction of new technologies that improve the way surgical treatments are planned and performed [...]
A method to study and evaluate the occupation of a Hospital Surgery Service, with some specificity in its activity, is outlined in this work. Its application is exemplified with real data, and it is shown that it is simple, practical, and useful and allows a practical management of the service occupation.
In this study, we present an implementation strategy for a robot that performs peg transfer tasks in Fundamentals of Laparoscopic Surgery (FLS) via imitation learning, aimed at the development of an autonomous robot for laparoscopic surgery. Robotic laparoscopic surgery presents two main challenges: (1) the need to manipulate forceps using ports established on the body surface as fulcrums, and (2) difficulty in perceiving depth information when working with a monocular camera that displays its images on a monitor. Especially, regarding issue (2), most prior research has assumed the availability of depth images or models of a target to be operated on. Therefore, in this study, we achieve more accurate imitation learning with only monocular images by extracting motion constraints from one exemplary motion of skilled operators, collecting data based on these constraints, and conducting imitation learning based on the collected data. We implemented an overall system using two Franka Emika Panda Robot Arms and validated its effectiveness.
ObjectiveThe present study intends to observe the cleaning effect of different detection methods in cleaning silicone tubes used in phacoemulsification.MethodsA total of 100 silicone tubes were selected randomly after surgery. The silicone tubes were retained for ≤2 hours after surgery, and then washed with a high-pressure water gun at a flow rate of 12~14 ml/s. Adenosine Triphosphate (ATP) detection and quantitation of residual protein were performed on the samples before cleaning and after washing for 30 s, 40 s, and 50 s, respectively, including the sample surface and the water after cleaning.ResultsAccording to the results before and after cleaning the silicone tube, there are significant differences in three methods of quantitation of residual protein, ATP detection in water sample, and ATP detection in sample surface (c2=8.6, P<0.05), while having no difference between the three methods after washing for 30 s, 40 s and 50 s, respectively (c2=4.918 and 5.571, P>0.05). A comparison of the means of ATP detection in water samples showed significant differences between rinses 30 s/40 s and 30 s/50 s. (Z=-7.45 and -0.08, P<0.05); pairwise contrast of ATP detection in sample surface for rinsing 30 s/40 s, 40 s/50 s, and 30 s/50 s showed significant differences (Z=3.64, 14.92, and 25.86, P<0.05). The quantitation of residual protein in silicone tubes showed pass rates of 84%, 100%, and 100% for 30 s, 40 s, and 50 s, respectively.ConclusionQuantitation of residual protein, ATP detection in water sample, and ATP detection in sample surface are available for monitoring the cleaning quality of silicone tube. The tube should be cleaned at a 12~14 ml/s flow rate and a washing time of ≥50 s.