Applying artificial intelligence to big data in hepatopancreatic and biliary surgery: a scoping review

Aim: Artificial Intelligence (AI) and its applications in healthcare are rapidly developing. The healthcare industry generates ever-increasing volumes of data that should be used to improve patient care. This review aims to examine the use of AI and its applications in hepatopancreatic and biliary (HPB) surgery, highlighting studies leveraging large datasets.Methods: A PRISMA-ScR compliant scoping review using Medline and Google Scholar databases was performed (5th August 2022). Studies focusing on the development and application of AI to HPB surgery were eligible for inclusion. We undertook a conceptual mapping exercise to identify key areas where AI is under active development for use in HPB surgery. We considered studies and concepts in the context of patient pathways - before surgery (including diagnostics), around the time of surgery (supporting interventions) and after surgery (including prognostication).Results: 98 studies were included. Most studies were performed in China or the USA (n = 45). Liver surgery was the most common area studied (n = 51). Research into AI in HPB surgery has increased rapidly in recent years, with almost two-thirds published since 2019 (61/98). Of these studies, 11 have focused on using “big data” to develop and apply AI models. Nine of these studies came from the USA and nearly all focused on the application of Natural Language Processing. We identified several critical conceptual areas where AI is under active development, including improving preoperative optimization, image guidance and sensor fusion-assisted surgery, surgical planning and simulation, natural language processing of clinical reports for deep phenotyping and prediction, and image-based machine learning.Conclusion: Applications of AI in HPB surgery primarily focus on image analysis and computer vision to address diagnostic and prognostic uncertainties. Virtual 3D and augmented reality models to support complex HPB interventions are also under active development and likely to be used in surgical planning and education. In addition, natural language processing may be helpful in the annotation and phenotyping of disease, leading to new scientific insights

Diseases of the Abdomen and Pelvis 2018-2021: Diagnostic Imaging - IDKD Book

Gastrointestinal disease; PET/CT; Radiology; X-ray; IDKD; Davo

Ultrasound Imaging

Ultrasound Imaging - Current Topics presents complex and current topics in ultrasound imaging in a simplified format. It is easy to read and exemplifies the range of experiences of each contributing author. Chapters address such topics as anatomy and dimensional variations, pediatric gastrointestinal emergencies, musculoskeletal and nerve imaging as well as molecular sonography. The book is a useful resource for researchers, students, clinicians, and sonographers looking for additional information on ultrasound imaging beyond the basics

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

25th International Congress of the European Association for Endoscopic Surgery (EAES) Frankfurt, Germany, 14-17 June 2017 : Oral Presentations

Introduction: Ouyang has recently proposed hiatal surface area (HSA) calculation by multiplanar multislice computer tomography (MDCT) scan as a useful tool for planning treatment of hiatus defects with hiatal hernia (HH), with or without gastroesophageal reflux (MRGE). Preoperative upper endoscopy or barium swallow cannot predict the HSA and pillars conditions. Aim to asses the efficacy of MDCT’s calculation of HSA for planning the best approach for the hiatal defects treatment. Methods: We retrospectively analyzed 25 patients, candidates to laparoscopic antireflux surgery as primary surgery or hiatus repair concomitant with or after bariatric surgery. Patients were analyzed preoperatively and after one-year follow-up by MDCT scan measurement of esophageal hiatus surface. Five normal patients were enrolled as control group. The HSA’s intraoperative calculation was performed after complete dissection of the area considered a triangle. Postoperative CT-scan was done after 12 months or any time reflux symptoms appeared. Results: (1) Mean HSA in control patients with no HH, no MRGE was cm2 and similar in non-complicated patients with previous LSG and cruroplasty. (2) Mean HSA in patients candidates to cruroplasty was 7.40 cm2. (3) Mean HSA in patients candidates to redo cruroplasty for recurrence was 10.11 cm2. Discussion. MDCT scan offer the possibility to obtain an objective measurement of the HSA and the correlation with endoscopic findings and symptoms. The preoperative information allow to discuss with patients the proper technique when a HSA[5 cm2 is detected. During the follow-up a correlation between symptoms and failure of cruroplasty can be assessed. Conclusions: MDCT scan seems to be an effective non-invasive method to plan hiatal defect treatment and to check during the follow-up the potential recurrence. Future research should correlate in larger series imaging data with intraoperative findings

Mastering Endo-Laparoscopic and Thoracoscopic Surgery

This is an open access book. The book focuses mainly on the surgical technique, OR setup, equipments and devices necessary in minimally invasive surgery (MIS). It serves as a compendium of endolaparoscopic surgical procedures. It is an official publication of the Endoscopic and Laparoscopic Surgeons of Asia (ELSA). The book includes various sections covering basic skills set, devices, equipments, OR setup, procedures by area. Each chapter cover introduction, indications and contraindications, pre-operative patient’s assessment and preparation, OT setup (instrumentation required, patient’s position, etc.), step by step description of surgical procedures, management of complications, post-operative care. It includes original illustrations for better understanding and visualization of specific procedures. The book serves as a practical guide for surgical residents, surgical trainees, surgical fellows, junior surgeons, surgical consultants and anyone interested in MIS. It covers most of the basic and advanced laparoscopic and thoracoscopic surgery procedures meeting the curriculum and examination requirements of the residents

Patterns of injury and violence in Yaoundé Cameroon: an analysis of hospital data.

BackgroundInjuries are quickly becoming a leading cause of death globally, disproportionately affecting sub-Saharan Africa, where reports on the epidemiology of injuries are extremely limited. Reports on the patterns and frequency of injuries are available from Cameroon are also scarce. This study explores the patterns of trauma seen at the emergency ward of the busiest trauma center in Cameroon's capital city.Materials and methodsAdministrative records from January 1, 2007, through December 31, 2007, were retrospectively reviewed; information on age, gender, mechanism of injury, and outcome was abstracted for all trauma patients presenting to the emergency ward. Univariate analysis was performed to assess patterns of injuries in terms of mechanism, date, age, and gender. Bivariate analysis was used to explore potential relationships between demographic variables and mechanism of injury.ResultsA total of 6,234 injured people were seen at the Central Hospital of Yaoundé's emergency ward during the year 2007. Males comprised 71% of those injured, and the mean age of injured patients was 29 years (SD = 14.9). Nearly 60% of the injuries were due to road traffic accidents, 46% of which involved a pedestrian. Intentional injuries were the second most common mechanism of injury (22.5%), 55% of which involved unarmed assault. Patients injured in falls were more likely to be admitted to the hospital (p < 0.001), whereas patients suffering intentional injuries and bites were less likely to be hospitalized (p < 0.001). Males were significantly more likely to be admitted than females (p < 0.001)DiscussionPatterns in terms of age, gender, and mechanism of injury are similar to reports from other countries from the same geographic region, but the magnitude of cases reported is high for a single institution in an African city the size of Yaoundé. As the burden of disease is predicted to increase dramatically in sub-Saharan Africa, immediate efforts in prevention and treatment in Cameroon are strongly warranted

Sappirakon hyvän- ja pahanlaatuisten sairauksien kirurginen hoito, komplikaatiot ja hoidon tulokset

Background: Laparoscopic cholecystectomy (LCC) is one of the most common surgical procedures. Surgery involves small, but noteworthy complication risks. Malignant changes in the pathology of the gallbladder are also rare. When gallbladder surgery is so common, this aspect of surgery can have an impact on a large portion of the population. Material and Methods: The Study I was a randomized controlled trial. We investigated whether 3D laparoscopic cholecystectomy would be faster and safer than a conventional laparoscopy in day surgery patients. The primary outcome was operation time. The Study II was a retrospective cohort study in which patients had been diagnosed with severe biliary injury (BDI). We studied the success of surgical treatment as well as the quality-of-life (QOL) of patients. The Studies III and IV addressed gallbladder cancer (GBC) in a retrospective study designs. Results: The Study I included 105 and 104 patients randomized to 3D and 2D LCC groups. The 3D system did not reduce the LCC operation time (3D vs 2D; 49.0 vs 48.0 min, p=0.703). The 3D technique did not either affect complications. The Study II included 52 patients with BDI and 53 patients without complications as controls. No difference in long-term (median 90 months) QOL was observed between groups. Three patients (5.8%) died from BDI. “Primary patency” was 71%. At one and five years, the “Actuarial primary patency rate” was 58% and 53%, respectively. Patency was achieved at 83% if the reconstructive surgery was primarily performed by a liver surgeon. In the Study III, GBC was rarely found (n = 10/2034; 0.5%) in the gallbladder, which was removed for benign reasons and no cancer was found in the macroscopically normal gallbladder. In the Study IV, we found 294 patients with GBC and revealed a low and slightly declining incidence of GBC in southern Finland. The proportion of patients who underwent curative surgery was 19%, and the five-year survival after curative-intent surgery was 57%. The five-year overall survival was 12% but without surgical or oncologic treatment 1.3%. Conclusions: Cholecystectomy is a common and safe procedure when the correct surgical technique and the possibility of anatomical variations are considered. The use of a 3D laparoscopy system does not improve the safety or efficacy. If a severe bile duct injury occurs, biliary reconstruction is recommended to be performed by a hepatobiliary surgeon. In a gallbladder sample removed for a benign reason, the use of selective histopathologic examination could save a substantial amount of health care resources. The prognosis of GBC is poor. Increasing the proportion of patients undergoing curative-intent resection and adjuvant therapy, as well as the use of neoadjuvant therapy, is likely to improve the prognosis of patients with GBC.Tausta: Laparoskooppinen sappirakonpoisto on yksi tavallisimmista toimenpiteistä. Leikkaukseen liittyy pieni, mutta huomionarvoinen komplikaatioriski. Harvinaisia ovat myös pahanlaatuiset muutokset sappirakon patologisessa tutkimuksessa. Kun sappirakon poistot ovat niin tavallisia, voi tällä kirurgian osa-alueella olla vaikutusta suureen väestön osaan. Materiaali ja menetelmät: Tämän väitöskirjan ensimmäinen osatyö oli satunnaistettu kontrolloitu tutkimus. Selvitimme siinä, olisiko 3D-laparoskooppinen sappirakonpoisto nopeampi ja turvallisempi kuin 2D-laparoskoopilla tehty toimenpide päiväkirurgisilla potilailla. Päävastemuuttuja oli leikkausaika. Toinen osatyö oli retrospektiivinen kohorttitutkimus, johon osallistuneilla potilailla oli todettu vakava sappitievaurio. Tutkimme kirurgisen hoidon onnistumista sekä potilaiden elämänlaatua. Kolmas ja neljäs osatyö käsittelivät sappirakon syöpää takautuvassa tutkimusasetelmassa. Tulokset: Osatyössä I, 105 ja 104 potilasta randomoitiin 3D- ja 2D-laparoskooppisiin sappirakonpoistoihin. 3D-järjestelmä ei nopeuttanut sappirakonpoiston leikkausaikaa (3D vs. 2D; 49,0 vs. 48,0 min, p = 0,703). Komplikaatioihin ei myöskään ollut vaikutusta. Osatyöhön II otettiin 52 sappitievaurion saanutta potilasta. Verrokkeina oli 53 potilasta ilman vauriota. Potilasryhmien välillä ei havaittu eroa pitkäaikaisessa (mediaani 90 kk) elämänlaadussa. Kolme potilasta (5,8 %) kuoli sappitievaurion vuoksi. ”Primary patency”, sappiteiden aukipysyvyyden aste, oli 71 %. Yhden ja viiden vuoden kohdalla ”Actuarial primary patency rate” oli 58 % ja 53 %. Avoimuus saavutettiin 83 %:lla, jos ensisijaisen korjausleikkauksen suoritti maksakirurgi. Osatyössä III sappirakon syöpä löytyi harvoin (n = 10/2034; 0,5 %) sappirakosta, joka poistettiin hyvänlaatuisista syistä eikä makroskooppisesti normaalista sappirakosta löytynyt syöpää. Osatyössä IV löysimme 294 syöpäpotilasta ja paljastimme matalan ja hieman laskevan sappirakon syövän ilmaantuvuuden Etelä-Suomessa. Kuratiivistavoitteisesti leikattujen leikkaukseen päätyneiden potilaiden osuus oli 19 %, ja kuratiivistavoitteisen leikkauksen jälkeen viiden vuoden eloonjääminen oli 57 %. Viiden vuoden kokonaiselossaoloaika on 12 %, mutta ilman kirurgisia tai onkologisia toimia 1,3 %. Johtopäätökset: Sappirakonpoisto on tavallinen ja turvallinen toimenpide, kun huomioidaan oikea kirurginen tekniikka ja anatomisten vaihtelujen mahdollisuus. 3D-laparoskopia ei paranna sappirakonpoiston turvallisuutta tai tehokkuutta. Vakavan sappitievaurion ilmaantuessa, maksakirurgin tulisi suorittaa korjaustoimenpide. Hyvänlaatuisesta syystä poistetussa sappirakkonäytteessä selektiivisen histopatologisen tutkimuksen käytöllä voitaisiin säästää huomattava määrä terveydenhuollon resursseja. Sappirakon syövän ennuste on huono. Lisäämällä kuratiivistavoitteisten leikkausten ja adjuvanttihoitoa saavien potilaiden määrää, sekä neoadjuvanttihoidon käyttöä, voitaisiin todennäköisesti parantaa sappirakon syöpäpotilaiden ennustetta

Diagnosis of Endometriosis

Endometriosis is defined as the presence of endometrial-like endometrial cells, glands, and stroma outside the uterus, causing a wide range of symptoms and signs, including acute and chronic pelvic pain and infertility. Endometriosis affects approximately 10% of women of reproductive age, and up to 50% of infertile women. The etiopathogenesis of endometriosis still remains controversial: immune, hormonal, genetic, and epigenetic factors may be all involved, and several theories have been proposed to explain it.One of the main problems for the management of endometriosis is the significant diagnostic delay: to date, several biomarkers are currently being tested in order to provide a reliable non-invasive diagnosis in case of symptoms and signs suspicious for endometriosis.In addition, ultrasound techniques and magnetic resonance imaging are evolving rapidly, allowing for better accuracy, even with the use of artificial intelligence. Finally, new potential histological makers are helping to correlate the occurrence of endometriosis in different anatomical landmarks, supporting specific pathways to clarify the etiology of the disease