Endoscopy : an evolving speciality

The practice of endoscopy has been rapidly changing due to new emerging technologies and novel techniques. There has been more focus on colonoscopy training with the development of structured programmes including simulators. Chromoendoscopy and magnification endoscopy have enabled improved diagnosis of small neoplastic lesions and will be important for the success of colorectal cancer screening programmes. The small bowel is now accessible to diagnostic modalities like capsule endoscopy and to therapeutic tools through the double balloon enteroscope. Endoscopic therapy has also become more sophisticated with endoscopic therapy of reflux disease now possible. Excision of large colorectal adenomatous polyps by endoscopic mucosal resection and dissection of submucosal tumours may reduce the need for surgical intervention. The practice of endoscopy has rapidly changed over the past few years. What was once a simple diagnostic procedure made possible by the development of fibre optics has become a speciality in its own right. This article will highlight some aspects of endoscopic practice that have undergone major changes over the past few years and that will shape endoscopy practice in the future.peer-reviewe

Generative Adversarial Networks (GANs) for Simulating Human Behaviors during Bone Registration to Improve Registration Algorithms

Computer-assisted orthopedic surgical procedures routinely require the registration of a bone to preoperative surgical planning data. The registration procedure requires the collection of points on the bone that are then matched to points or surfaces on a 3-D bone model. To improve the registration algorithms, simulations of the real-world registration processer are performed to test the changes to the algorithms. The present publication proposes the use of generative adversarial networks (GANs) to generate registration simulation data that closely matches that of real-world experimental/actual data

Pre-operative Visualization of Remaining Bone after Robotic Cutting

A method to pre-operatively display bone that may remain after robotic cutting in total joint arthroplasty. The method includes the use of a 3-D bone model, a 3-D implant model, and a cut volume. A user plans a position of the 3-D implant model relative to the 3-D bone model to designated the best fit, fill, or alignment for a final implant on a bone. The 3-D bone model is then split at the ideal plane definitions where the implant planar surfaces intersect with the bone model. Next, the cut volume is subtracted from the planar removal elements to create a set of volumes that define the bone that will remain after robotic cutting. The 3-D bone model with the simulated cut and remaining bone is displayed to the user, which may assist with planning for the procedure

Determining the Reliability of a Robotic Surgical System for Producing Good Clinical Outcomes

A method to determine the reliability of a robotic surgical system for producing good clinical outcomes is described herein. The method utilizes machine learning (ML) or artificial intelligence (AI) to classify, analyze, or rank how reliable a robotic system is at producing good clinical outcomes as a function of patient specific factors, medical staff factors, robotic system factors, and/or intraoperative factors. A plurality of potential inputs for the ML or AI algorithms is provided as well as the possible outputs for a given robotic system. The method may be particularly useful for surgical robot manufacturers, surgeons, and health care facilities

European Society of Surgical Oncology's strategy for clinical research : Paving the way for a culture of research in cancer surgery

As part of its mission to promote the best surgical care for cancer patients, the European Society of Surgical Oncology (ESSO) has been developing multiple programmes for clinical research along with its educational portfolio. This position paper describes the different research activities of the Society over the past decade and an action plan for the upcoming five years to lead innovative and high quality surgical oncology research. ESSO proposes to consider pragmatic research methodologies as a complement to randomised clinical trials (RCT), advocates for increased funding and operational support in conducting research and aims to enable young surgeons to be active in research and establish partnerships for translational research activities. (C) 2019 Published by Elsevier Ltd.Peer reviewe

Surgical and non-surgical prosthetic hands control: a review

This paper concerns on the review between the surgical and non-surgical method of active control of a prosthetic hand. For active prosthetic hand, there are two standard methods for signal extraction namely surgical and non-surgical. Active prosthetic hands which are based on Surface Electromyography (sEMG) and Targeted Muscle Reinnervation (TMR) are selected for a comparison between non-surgical and surgical type respectively. We made a review on the characteristics and procedures of the surgical and non-surgical prosthetic hand technique. The compatibility of the surgical and non-surgical method to the type of upper extremity amputations also discussed to propose a guide and baseline for the future design consideration for our future prosthetic hand design

What Makes AI ‘Intelligent’ and ‘Caring’?:Exploring Affect and Relationality Across Three Sites of Intelligence and Care

This research was funded in whole by the Wellcome Trust [Seed Award ‘AI and Health’ 213643/Z/18/Z]. For the purpose of Open Access, the authors have applied a CC BY public copyright licence to any Author Accepted Manuscript version arising from this submission. The authors would like to thank Dr Jane Hopton for inspiring discussions about AI and dimensions of intelligence, and three anonymous reviewers as well as the editor in chief Dr Timmemans at Social Science and Medicine for their very helpful and constructive feedback.Peer reviewedPublisher PD

The challenges faced in the design, conduct and analysis of surgical randomised trials

Randomised evaluations of surgical interventions are rare; some interventions have been widely adopted without rigorous evaluation. Unlike other medical areas, the randomised controlled trial (RCT) design has not become the default study design for the evaluation of surgical interventions. Surgical trials are difficult to successfully undertake and pose particular practical and methodological challenges. However, RCTs have played a role in the assessment of surgical innovations and there is scope and need for greater use. This article will consider the design, conduct and analysis of an RCT of a surgical intervention. The issues will be reviewed under three headings: the timing of the evaluation, defining the research question and trial design issues. Recommendations on the conduct of future surgical RCTs are made. Collaboration between research and surgical communities is needed to address the distinct issues raised by the assessment of surgical interventions and enable the conduct of appropriate and well-designed trials