Choice of function-preserving gastrectomy / 中华胃肠外科杂志

As the diagnosis rate of early gastric cancer is increasing annually, the current hot spot in the treatment of early gastric cancer is how to better preserve the anatomical structure and physiological function of the stomach and improve the quality of life of patients after surgery under the premise of tumor eradication. Therefore, function-preserving gastrectomy has been the trend of surgical treatment for early gastric cancer. It is not just a modified gastrectomy, but a better combination of improved surgical techniques and the concept of function-preserving treatment, rather than being limited to traditional surgical treatments. Currently, the routine function-preserving gastrectomy mainly includes pylorus-preserving gastrectomy, proximal gastrectomy and partial gastrectomy combined with endoscopy. In addition, with the deeper understanding of metastasis pattern of gastric cancer and the development and popularization of minimally invasive techniques, laparoscopic and endoscopic cooperative surgery is gradually gaining attention. The application of laparoscopic and endoscopic hybrid surgery combined with sentinel lymph node navigation is anticipated in the treatment of early gastric cancer.

Computer-assisted navigation in orbitofacial surgery

The purpose of this systematic review is to investigate the most common indications, treatment, and outcomes of computer-assisted surgery (CAS) in ophthalmological practice. CAS has evolved over the years from a neurosurgical tool to maxillofacial as well as an instrument to orbitofacial surgeries. A detailed and organized scrutiny in relevant electronic databases, journals, and bibliographies of the cited articles was carried out. Clinical studies with a minimum of two study cases were included. Navigation surgery, posttraumatic orbital reconstruction, computer-assisted orbital surgery, image-guided orbital decompression, and optic canal decompression (OCD) were the areas of interest. The search generated 42 articles describing the use of navigation in facial surgery: 22 on orbital reconstructions, 5 related to lacrimal sac surgery, 4 on orbital decompression, 2 articles each on intraorbital foreign body and intraorbital tumors, 2 on faciomaxillary surgeries, 3 on cranial surgery, and 2 articles on navigation-guided OCD in traumatic optic neuropathy. In general, CAS is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were related to trauma. Treatment of complex orbital fractures was greatly improved by the use of CAS compared with empirically treated control groups. CAS seems to add a favourable potential to the surgical armamentarium. Planning details of the surgical approach in a three-dimensional virtual environment and execution with real-time guidance can help in considerable enhancement of precision. Financial investments and steep learning curve are the main hindrances to its popularity.

The value and key point of function preserving gastrectomy in early gastric cancer / 中国实用外科杂志

With the detection rate of early gastric cancer increases annually, more and more patients can survive for a long time after surgery. Thus, surgeons have paid more attention to preserve the function of the remnant stomach, limit the surgical trauma and improve the quality of life. Pylorus-preserving gastrectomy andlocal gastrectomy are the most common kind of function preserving gastrectomy. The key points we concern are whether they will bring about the risk of radical tumors, whether they will increase the occurrence of surgical complications and whether they are difficult to popularize. The systematic and in-depth study of the key aspects of these function preserving gastrectomy and the provision of a strong evidence-based medical basis will contribute to a new round of innovation in the surgical treatment of early gastric cancer.

Application of digital intelligent diagnostic and treatment technology in anatomical hepatectomy / 中国实用外科杂志

Digital intelligent diagnostic and treatment technology refers to a novel technology which is based by associating digitalized and intelligent high-tech with modern science to form a multi-knowledge and multi-disciplinary domain; it includes three-dimensional visualization,3 D printing,molecular fluorescence imaging,mixed reality,photoacoustic imaging,artificial intelligence-radiomis and real-time multimodal image surgical navigation.It plays a significant role in precision diagnosis,preoperative planning and intraoperative navigation of diseases.The authors' team,combining digital intelligent technology with the actual vascular distribution of patients,has been committed to the realization of individualized liver segmentation,volume calculation,simulation surgery,preoperative planning,mixed reality,tumor boundary definition and real-time image fusion for navigation in liver surgery.The research results were applied clinically,and achieved anatomical,functional,and radical hepatectomy for liver tumors.

Current Status and Future Perspectives on Minimally Invasive Esophagectomy

Esophageal cancer has one of the highest malignant potentials of any type of tumor. The 3-field lymph node dissection is the standard procedure in Japan for surgically curable esophageal cancer in the middle or upper thoracic esophagus. Minimally invasive esophagectomy is being increasingly performed in many countries, and several studies report its feasibility and curability; further, the magnifying effect of the thoracoscope is another distinct advantage. However, few studies have reported that minimally invasive esophagectomy is more beneficial than open esophagectomy. A recent meta-analysis revealed that minimally invasive esophagectomy reduces blood loss, respiratory complications, the total morbidity rate, and hospitalization duration. A randomized study reported that the pulmonary infection rate, pain score, intraoperative blood loss, hospitalization duration, and postoperative 6-week quality of life were significantly better with the minimally invasive procedure than with other procedures. In the future, sentinel lymph node mapping might play a significant role by obtaining individualized information to customize the surgical procedure for individual patients' specific needs.

The current status and future perspectives of laparoscopic surgery for gastric cancer / 대한외과학회지

Gastric cancer is most common cancer in Korea. Surgery is still the main axis of treatment. Due to early detection of gastric cancer, the innovation of surgical instruments and technological advances, gastric cancer treatment is now shifting to a new era. One of the most astonishing changes is that minimally invasive surgery (MIS) is becoming more dominant treatment for early gastric cancer. These MIS are represented by endoscopic resection, laparoscopic surgery, robotic surgery, single-port surgery and natural orifice transluminal endoscopic surgery. Among them, laparoscopic gastrectomy is most actively performed in the field of surgery. Laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer (EGC) has already gained popularity in terms of the short-term outcomes including patient's quality of life. We only have to wait for the long-term oncologic results of Korean Laparoscopic Gastrointestinal Surgery Study Group. Upcoming top issues following oncologic safety of LADG are function-preserving surgery for EGC, application of laparoscopy to advanced gastric cancer and sentinel lymph node navigation surgery. In the aspect of technique, laparoscopic surgery at present could reproduce almost the whole open procedures. However, the other fields mentioned above need more evidences and experiences. All these new ideas and attempts provide technical advances, which will minimize surgical insults and maximize the surgical outcomes and the quality of life of patients.

Measurement and Algorithm Calculation of Maxillary Positioning Change by Use of an Optoelectronic Tracking System Marker in Orthognathic Surgery

USE OF A COMPUTER NAVIGATION SYSTEM FOR OSTEOTOMIES IN THE ORTHOGNATHIC SURGERY: TECHNICAL NOTE

Development and application of stent-based image guided navigation system for oral and maxillofacial surgery / 대한구강악안면방사선학회지

PURPOSE: The purpose of this study was to develop a stent-based image guided surgery system and to apply it to oral and maxillofacial surgeries for anatomically complex sites. MATERIALS AND METHODS: We devised a patient-specific stent for patient-to-image registration and navigation. Threedimensional positions of the reference probe and the tool probe were tracked by an optical camera system and the relative position of the handpiece drill tip to the reference probe was monitored continuously on the monitor of a PC. Using 8 landmarks for measuring accuracy, the spatial discrepancy between CT image coordinate and physical coordinate was calculated for testing the normality. RESULTS: The accuracy over 8 anatomical landmarks showed an overall mean of 0.56+/-0.16 mm. The developed system was applied to a surgery for a vertical alveolar bone augmentation in right mandibular posterior area and possible interior alveolar nerve injury case of an impacted third molar. The developed system provided continuous monitoring of invisible anatomical structures during operation and 3D information for operation sites. The clinical challenge showed sufficient accuracy and availability of anatomically complex operation sites. CONCLUSION: The developed system showed sufficient accuracy and availability in oral and maxillofacial surgeries for anatomically complex sites.

Application of fluoro-navigation technology in orthopaedics and traumatology / 中华创伤骨科杂志

Fluoro-navigation technology becomes more and more important in orthopaedic surgery. Because of preoperative alteration in fracture fragment orientation it is necessary to complete the fracture reduction before fluoroscopic image acquisition and surgery assisted with navigation. The advantages of the fluoro-navigation technology include minimal X-ray exposure, accurate positioning of implants, real time interactive quantitative data of the images, and minimally invasive surgery. With further development and improvement of both software and hardware, many operations, which require X-ray monitoring, can be conducted with the help of fluoro-navigation technology. Our past 4-year clinical experiences confirm the above advantages and its potential applications. As the technology of fluoro-navigation is still under improvement, further evaluation and validation is necessary to confirm its clinical values. In addition, fluoro-navigationsystems may play an important role in virtual surgical training and assessment. It may provide not only training opportunities to young surgeons but also an objective assessment system for evaluating proficiency of surgical techniques.