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Background: Trauma surgery is a fundamental aspect of medicine. According to the 2023 mortality report from Statistics Korea, external factors such as intentional self-harm and transportation incidents are leading causes of death among individuals aged 10 to 30, accounting for 7.9% of overall mortality. Despite advances in the field, specialization has hindered comprehensive trauma care. Main body: In South Korea, regional trauma centers have been established to meet critical trauma management needs; however, challenges remain, including a shortage of trauma surgeons and inefficient resource utilization. The reluctance of surgical residents to pursue trauma training exacerbates the scarcity of qualified specialists. Trauma surgeons often bear extensive responsibilities, which limits their ability to perform prompt interventions. Acute Care Surgery (ACS) offers a model to integrate trauma and non-trauma surgical care, enabling hospitals to implement effective protocols for urgent cases and improving patient outcomes. Research indicates that ACS enhances emergency surgical management, increases training opportunities for residents, and improves job satisfaction among participating surgeons. Conclusion: Integrating ACS into South Korea's healthcare system is essential to optimize resource allocation and improve emergency care, ultimately leading to enhanced public health outcomes. [ABSTRACT FROM AUTHOR]

Background: The emergence of 3D printing has revolutionized medical training and preoperative planning. However, existing models have limitations, prompting the development of newly designed flexible 3D-printed bone fracture models. Methods: The designed flexible 3D-printed bone fracture models were evaluated by 133 trauma surgeons with different levels of experience for perceived value as educational tool or as preoperative planning tool. Results: The models allowed drilling and showed resistance to manipulation and sterilization. Surgeons found the flexible model helpful for teaching and planning the reduction of fractures, planning and simulating osteosynthesis, understanding fractures, visualizing fractures, and planning surgical approaches. Conclusions: Flexible 3D-printed bone fracture models offer a dynamic and realistic approach to understanding complex fractures, potentially improving surgical training and preoperative planning. [ABSTRACT FROM AUTHOR]

Background: The demographics of medical schools reveal a growing trend towards greater gender and underrepresented in medicine (UIM) representation among students, yet surgical residency lags behind. This study explores the demographics of first-year medical students (M1s) and their initial career interests. Methods: A panel of faculty physicians and fourth-year medical students in surgical and nonsurgical specialties was held for M1s during orientation week. Demographic differences and career interests were collected. Results: Fifty-six M1s, 31 (55%) female and 13 (24%) UIM, attended the event. While 35 students (62.5%) reported interest in surgery, only 7 (20%) identified as UIM and 16 (46%) as female. Conclusion: Initial interest in surgery is comprised of mostly male and non-UIM students. Throughout medical school, this pattern persists, with current match rates into surgery not reflecting the population of students. Focusing on initial interest to surgery is crucial as it is the foundation for the pipeline of diversifying future surgeons. [ABSTRACT FROM AUTHOR]

The document provides abstracts from the 28th Congress of the Spanish Society for Surgery Research in 2024, covering a wide range of topics such as implantable devices for drug delivery, flow dynamics simulation, soft skills training in residency, nerve regeneration, and vascular graft studies. Research includes investigations into treatments for myocardial infarction, vascular graft development, and the therapeutic use of menstrual blood-derived stromal cells for heart attack management. Other studies focus on predicting small intestine length for bariatric surgery, predictive algorithms for bariatric surgery, advanced therapies for post-myocardial infarction ventricular dysfunction, and surgical skills training in fetoscopy and fetal surgery. The document also delves into laparoscopic ureteral obstruction modeling, artificial intelligence in robotic surgery education, vascular graft validation, endovascular procedures for stroke in large animals, and bioinformatic analyses on the therapeutic potential of secretomes from menstrual blood-derived stromal cells. [Extracted from the article]

Anatomical structures of the liver could be reconstructed three dimensionally from preoperative cross-sectional imaging for over 20 years. This three-dimensional (3D) representation not only optimizes the preoperative planning options but also the communication of specific operation-relevant structures can be improved using 3D models. In addition to a plastic and interactive visualization of 3D organ models, the disruptive technology of virtual reality (VR) can also provide a possibility for structured training and further education regarding surgical anatomy of the liver and operation planning. This makes examinations in virtual reality also seem tangible. The latest prototypes even enable patient-specific simulation of intraoperative sonography. This review article provides an overview of the current status of available technologies for training and further education using VR exemplified by liver surgery. [ABSTRACT FROM AUTHOR]

Background: As the field of surgery continues to evolve, subspecialty training is fast becoming integral to surgical education. Presently, orthopaedic surgery residents have opportunities to subspecialise in different areas. Objectives: The aim of this study was to determine the factors affecting the choice of desired subspecialties amongst orthopaedic surgery residents in southern Nigeria. Materials and Methods: This study was a cross-sectional study conducted amongst senior orthopaedic surgery residents in southern Nigeria. A well-structured questionnaire designed using the free software Google Forms was electronically distributed to senior orthopaedic residents in Nigeria through online forums (WhatsApp, email, and Telegram). Data obtained were analysed using IBM Statistical Product and Service Solutions version 26. The odds ratio and the associated 95% confidence interval were used to assess outcomes, and a P value <0.05 defined that the difference was statistically significant. Results: At the end of the study period, 53 orthopaedic surgery senior residents completed and submitted the questionnaire with a response rate of 73.6%; 50.9% were married with children and 49.1% were single. The most agreed key factor influencing the choice of orthopaedic surgery subspecialisation from the study was lifestyle considerations (79.2%). Other major factors considered to be also very important were the needs of the region (73.6%), active mentorship (71.7%), ergonomics (64.6%), rotation experiences (47.2%), cost of acquiring the training (41.5%), and salary and financial privileges (37.7%). Overall, 24.5% of respondents chose spine surgery as their desired subspecialty, 18.9% arthroplasty, 17% arthroscopy, 17% paediatrics, 13.2% reconstructive orthopaedics, 5.7% musculoskeletal oncology, and 4.7% hand and foot surgery. Our study revealed a significant statistical relationship between having children and choice of a subspecialty (Fischer's = 0.032; χ2 = 0.033), as the married female residents tend to have more family considerations in their final choice of subspecialisation. Conclusion: The choice of orthopaedic surgery subspecialisation amongst orthopaedic surgery residents in southern Nigeria is affected by different factors, such as mentorship, needs of region, desire to work in academic settings, and ergonomics. [ABSTRACT FROM AUTHOR]

Background: The Fundamentals of Leadership Development (FLD) Curriculum was created to increase integration of diversity, equity, and inclusion (DEI) in leadership skills. The pilot FLD course was utilized 1) evaluate short-term impact of the curriculum, and 2) evaluate optimal delivery methods of curricular interventions on diversity in a leadership context in a randomized fashion. Methods: After IRB approval, the pilot FLD course was opened to all SAGES Committee members for enrollment. All participants had access to the same online modules and discussion forum, but were randomized either to a 4-week longitudinal or 2-day intensive didactic session. Participants were asked to assess the curricular content after each online module and provide overall course feedback on all sessions. This data was collected along with leadership experience, course participation, and course completion data. Results: A total of 79 participants registered for the FLD course, with 55 (69.7%) of participants completing the course. Of those that registered, 46 (58.2%) self-identified as underrepresented in medicine, 32 (40.5%) self-identified with she/her/hers pronouns, and 45 (57.0%) held an institutional leadership position. Fifty-nine (74.6%) participants were willing to be randomized. Course engagement was higher in the intensive course with 64.1% and 48.7% participation over days 1 and 2, respectively. In the longitudinal course, participation dropped off every week from 70%, 47.5%, 35%, and 27.5%, throughout the 4-week course. Participants who accessed the online modules spent a median time of 3 h and 34 min. User confidence after completion of each individual module were "somewhat confident" and "completely confident" for almost all survey respondents on a 5-tier Likert scale. Conclusions: The pilot FLD course appealed to SAGES members in leadership roles and who identified as. URiM. Course engagement was higher in the intensive course. Long-term behavior changes after course completion will need to be assessed with additional qualitative interviews. (300/300 words). [ABSTRACT FROM AUTHOR]

Background: Significant disparities exist in laparoscopic training opportunities for surgeons in low- and middle-income countries (LMICs). ALL-SAFE is an innovative, low-cost training system for LMIC surgeons' laparoscopic development. However, strategies to implement and scale ALL-SAFE are unstudied. We aimed to assess the impact of implementation science strategies on ALL-SAFE uptake in Liberia, a novel and low-resource context. Methods: This study used implementation science approaches to evaluate ALL-SAFE uptake in three Liberian hospitals: John F. Kennedy Medical Center, Phebe, and ELWA. Five validated implementation strategies of program orientation, local champions, network weaving, feedback mechanisms, and practical supervision were piloted. All five strategies were implemented at two hospitals, while four strategies, excluding clinician supervision, were implemented at the final site as a pseudo-control, to evaluate the impact of resource-intensive supervision. Participants included surgical consultants, residents, and medical students. Engagement was assessed with mixed methods including participant number, practice hours, module completion rates, and strategy feasibility through end-user interviews. Results: Across three hospitals, 33 participants used ALL-SAFE for 87.8 total training hours (5,268 min). Participant numbers varied across sites (NJFK = 20, 80%; NPhebe = 7, 88%; NELWA = 6, 86%), as did practice times (TotalJFK = 3,060 min, Median time/ParticipantJFK = 103 min; TotalPhebe = 1,434 min, Median time/ParticipantPhebe = 126 min; TotalELWA = 774 min, Median time/ParticipantELWA = 100 min). Sites with practical supervision demonstrated higher engagement than those without (P = 0.042). Interviews (n = 8) revealed positive perceptions toward program orientation, practical supervision, and network weaving. Participants recommended thirteen additional strategies for sustainability including translating ALL-SAFE skills to patient care. Conclusion: Our study is one of the first to evaluate implementation science strategies for laparoscopic training in sub-Saharan Africa. The implementation bundles of five validated strategies were considered feasible by Liberian surgeons in both urban and rural hospitals. Mixed methods suggested a positive association between engagement and the resource-intensive practical supervision strategy. Future studies should focus on quantifying individual strategy contributions with rigorous implementation designs and assessing sustainability strategies. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Despite advances in medical education and professional opportunities, orthopaedic surgery remains the least gender‐diverse medical specialty, with women significantly underrepresented globally. This scoping review aims to synthesize existing literature to provide a comprehensive overview of the barriers and facilitators encountered by females in orthopaedic surgery training and practice.A comprehensive search of Medline (OVID), Scopus, Embase, Emcare, and CINAHL was performed from inception to 14 July 2024. Additional sources were identified via citation searching and Google Scholar. Any primary studies employing qualitative, quantitative, or mixed methods approaches to explore barriers and facilitators experienced by female orthopaedic trainees and consultants in high‐income countries. Quality analysis of included articles was conducted using the Mixed Methods Appraisal Tool.Seventy‐nine studies met the inclusion criteria, involving over 100 000 participants between 1993 and 2024. Most studies were cross‐sectional surveys. Sixty‐eight barriers and 38 facilitators were identified. Analysis using the Socio‐Ecological Model revealed the complex interplay of factors at the individual, interpersonal, organizational, community, and policy levels. The largest proportion of barriers and facilitators resided at the organizational level.This scoping review provides a comprehensive mapping of current evidence on barriers and facilitators for female practitioners in orthopaedic surgery training and practice. The findings suggest the need for multifaceted interventions to promote gender equity. Future research should evaluate the effectiveness of specific interventions and develop strategies to support women in orthopaedics, ultimately contributing to a more inclusive and diverse workforce. [ABSTRACT FROM AUTHOR]

Microsurgical reconstruction constitutes a fundamental part of plastic and reconstructive surgery. It demands high dexterity and intricate technical skills. Its steep learning curve benefits from thorough training throughout residency, where using realistic simulation models in the appropriate sequence of complexity progression is essential in ensuring patient safety prior to progressing to a clinical setting. Commencing training on microvascular-like small diameter vessels could prove unsuitable and ineffective for inexperienced surgeons, however, the larger diameter neurovascular structures in the porcine thigh can provide excellent anastomotic training without compromising the animal tissue training sought after by residents. We present the results from implementing the first vascular anastomotic course in our country, where reconstructive theory was combined with simulated anastomotic training on the porcine thigh. Junior plastic surgery residents described acquiring comprehensive knowledge of reconstructive techniques and could successfully complete anastomoses, despite none to minimal previous experience. Using the porcine thigh should be encouraged as a start-up vascular anastomotic training tool as it provides realistic conditions and tissue handling training, and could improve quality of further training on microvascular structures. [ABSTRACT FROM AUTHOR]

Purpose: To identify the problems trainees face during surgical training in Japan. Methods: A nationwide online questionnaire survey was conducted targeting newly certified surgical trainees. Results: The response rate was 53.8% (758/1410). Among those respondents, 25.6% were women, 71.4% were either married or had a partner, 41.3% had children, 72.7% had performed over 200 surgeries under general anesthesia, and 54.1% had chosen, before graduating from medical school, to become a surgeon. While 88.8% were interested in learning surgical techniques, 63.8% were hesitant to become a surgeon for fear of a compromised quality of private life (QOL). Conversely, only 1.4% chose their surgical training programs based on QOL. Overall, 84.6% of the trainees were satisfied with their training and this correlated with the number of surgeries performed. Only 29.9% received non-technical skill training. The average number of night shifts per month was 5.6, and 10.6% worked over 80 h per week. Harassment was reported by 41.5% of the respondents. Moreover, 33.0% had considered dropping out at some time, primarily because of their QOL (51.1%) or the harassment they had encountered (50.4%). Conclusion: This survey revealed that while trainees were satisfied with the overall training system, issues such as long working hours and harassment are prevalent. Working to improve these issues could make surgery more attractive for young trainees. [ABSTRACT FROM AUTHOR]

The article discusses the shift from a scored USMLE Step 1 exam to pass/fail grading, impacting the evaluation of orthopaedic surgery residency candidates. While high Step 1 scores were traditionally valued, the correlation between scores and resident performance remains uncertain. The change aims to reduce stress and encourage holistic evaluation, but concerns about increased pressure on research productivity and uncertainty in residency applications persist. Medical students experience varying levels of stress, with the impact of pass/fail scoring on overall wellness still unclear. [Extracted from the article]

Objective: This study aims to appraise recommendations from an expert panel of surgical educators on optimizing surgical education and training in the setting of contemporary challenges. Background: The Blue Ribbon Committee (BRC II), a group of surgical educators, was convened to make recommendations to optimize surgical training, considering the current changes in the landscape of surgical education. Surgical trainees were recruited to assess their impressions of the recommendations. Methods: A mixed-methods study design was employed, with a survey, followed by focus group interviews. Participating residents and fellows were recruited through a purposeful sampling approach. Descriptive statistics were applied to analyze the survey data, and a thematic data analysis on interview transcripts was employed. Results: The majority of trainee respondents (n=16) thought that all of the subcommittee recommendations should be included in the final BRC II recommendations and paper. According to the interviews, overall, the feedback from the trainees was positive, with particular excitement around work-life integration, education support and faculty development, and funding pitfalls. Some themes about concerns included a lack of clarity about the recommendations, concern about some recommendations being in conflict with one another, and a disconnect between the initial BRC II survey and the subsequent recommendations. Conclusions: The residents gathered for this focus group were encouraged by the thought, effort, and intention that gathered the surgical leaders across the country to make the recommendations. While the trainees wanted clarity on some areas, the overall opinion was in agreement with the recommendations. [ABSTRACT FROM AUTHOR]

Objective: Describe the latest technological in surgical education and assessment. Background: Surgical education is challenged by continuously increasing clinical content, greater subspecialization, and public scrutiny of access to high-quality surgical care. Since the last Blue Ribbon Committee on surgical education, novel technologies have been developed, including artificial intelligence and telecommunication. Methods: The goals of this Blue Ribbon Sub-Committee were to construct a framework for applying these technologies to improve the effectiveness and efficiency of surgical education and assessment. An additional goal was to identify implementation frameworks and strategies for centers with different resources and access. All subcommittee recommendations were included in a Delphi consensus process with the entire Blue Ribbon Committee (N = 67). Results: Our subcommittee found several new technologies and opportunities that are well-poised to improve the effectiveness and efficiency of surgical education and assessment (Tables 1–3). Our top recommendation was that a Multidisciplinary Surgical Educational Council be established to serve as an oversight body to develop consensus, facilitate implementation, and establish best practices for technology implementation and assessment. This recommendation achieved 93% consensus during the first round of the Delphi process. Conclusions: Advances in technology-based assessment, data analytics, and behavioral analysis now allow us to create personalized educational programs based on individual preferences and learning styles. If implemented properly, education technology has the promise of improving the quality and efficiency of surgical education and decreasing the demands on clinical faculty. [ABSTRACT FROM AUTHOR]

Objective: To review the current state of research training during surgical residency and make recommendations commensurate with current surgical training and academic environment. Background: Research training has been a mainstay of academic surgical programs, yet the scientific disciplines have evolved significantly from the traditional years of bench research. It is time to reconsider how research training should prepare surgeons for future academic practice and ensure the foundational knowledge of research evidence. Methods: As part of the Blue Ribbon Committee II, a research subcommittee was tasked to make recommendations on research training during surgical residency. Our 8-member panel brought diverse perspectives on the roles and goals of research training. We also sought input from a convenience sample of current and recent surgical residents on the impact of research training during their residency. Results: We identified a lack of a common framework and foundational research training for all surgical residents. Participation in dedicated years of scholarly activity helped trainees meet several professional and personal goals. The lack of an integrated, dedicated research track may dissuade some medical school graduates from pursuing surgery. Conclusions: We recommend incorporating a minimum standard for all trainees and flexibility in dedicated scholarly training to meet the needs of future academic surgeons. [ABSTRACT FROM AUTHOR]

Objective: To update and add to the first report commissioned by the Blue Ribbon Committee (BRC) about 20 years prior. Background: Following a summit in late 2022 commissioned by the American Board of Surgery regarding competency-based reforms in surgical education and through a partnership with the American College of Surgeons and other stakeholders, a BRC-II on surgical education was formed. The BRC-II would have 7 subcommittees. This paper details the work of the Medical Student Subcommittee within the BRC-II. Methods: The subcommittee's work, supported by staff from the American College of Surgeons, entailed a thorough literature review, which involved collating and aggregating the findings, identifying key challenges and opportunities, and committing to draft recommendations. These recommendations were then presented and refined through discussions with the BRC at large in multiple virtual and in-person settings. Results: The subcommittee's work is detailed below and further summarized in table format. The section below elucidates the medical student education continuum and discusses the pertinent topics of recruitment, surgical engagement in medical student training and the surgical image, training for the current surgical practice model, trainee selection for graduate medical education, and optimizing the transition from undergraduate medical education to graduate medical education. Conclusions: The last 2 decades have shown significant changes and shifts in medical education and surgical practice. The findings of BRC-II in this manuscript help to structure the current and future necessary improvements, focusing on different aspects of medical student education. [ABSTRACT FROM AUTHOR]

Objective: Review the subsequent impact of recommendations made by the 2004 American Surgical Association Blue Ribbon Committee (BRC I) Report on Surgical Education. Background: Current leaders of the American College of Surgeons and the American Surgical Association convened an expert panel to review the impact of the BRC I report and make recommendations for future improvements in surgical education. Methods: BRC I members reviewed the 2004 recommendations in light of the current status of surgical education. Results: Some of the recommendations of BRC I have gained traction and have been implemented. There is a well-organized national curriculum and numerous educational offerings. There has been greater emphasis on preparing faculty to teach, and there are ample opportunities for professional advancement as an educator. The number of residents has grown, although not at a pace to meet the country's needs either by total number or geographic distribution. The number of women in the profession has increased. There is greater awareness and attention to resident (and faculty) well-being. The anticipated radical change in the educational scheme has not been adopted. Training in surgical research still depends on the resources and interests of individual programs. Financing student and graduate medical education remains a challenge. Conclusions: The medical landscape has changed considerably since BRC I published its findings in 2005. A contemporary assessment of surgical education and training is needed to meet the future needs of the profession and our patients. [ABSTRACT FROM AUTHOR]

Background: Penile implant surgery is the standard surgical treatment for end-stage erectile dysfunction. However, the growing complexity of modern high-tech penile prostheses has increased the demand for more practical training opportunities. The most advanced contemporary training methods involve simulation training using cadavers, with costs exceeding $5,000 per cadaver, inclusive of biohazard fees. This study introduces an innovative and cost-efficient male urogenital simulator designed to enhance penile implant surgery training. Methods: Utilizing image segmentation of patient pre-operative computed tomography (CT) scans, combined with three-dimensional (3D) printing and silicone molding techniques, we developed a high-fidelity simulator replicating the anatomical structures of the male urogenital system. The simulator incorporates an innovative double-layer structural design encompassing the corpus spongiosum and glans, corpora cavernosa, testes, epididymides, and pelvic bones. Additionally, it utilizes a two-stage skin manufacturing process tailored for different skin regions. The simulator was produced at a low material cost of £10, with an average production time of 3 h. To evaluate its training efficacy, we conducted a penile implant surgery training session involving 15 urology trainees and surgeons ranging from specialty training levels ST3 to ST6. The session began with a demonstration of penile implant surgery and error detection. Trainees, averaging three per simulator, practiced corporotomy, dilation, measurement, penile prosthesis, and scrotal pump placement under expert guidance. Participants' feedback was collected using a Likert scale questionnaire, assessing learning, satisfaction, and anatomical accuracy. Results: Quantitative analysis of the questionnaire responses indicated highly positive feedback from the participants. Satisfaction rates surpassed 96% in learning effectiveness, over 89% in overall satisfaction, and 86% in anatomical accuracy demonstration. The simulator was favourably reviewed by both urology trainees and experienced surgeons, highlighting its utility as a practical training tool. Its low production cost and high precision make it a viable alternative to current training models. Conclusions: The development of this cost-efficient, anatomically accurate urogenital simulator through advanced imaging and additive manufacturing techniques represents a significant advancement in penile implant surgical training. This state-of-the-art simulator not only provides a realistic and practical training experience but also underscores the potential for 3D printing technologies to revolutionize medical education and training. [ABSTRACT FROM AUTHOR]

The text is an interview with Dr. Jeffrey Drebin, President Elect of the American Surgical Association, discussing his work on mRNA vaccine therapy for pancreatic cancer. Dr. Drebin's research focuses on personalized mRNA vaccines targeting neoantigens in pancreatic cancer patients. He also discusses the use of neoadjuvant chemotherapy and radiotherapy for pancreatic cancer treatment. The interview highlights the importance of multimodal therapy for improving outcomes in pancreatic cancer patients, including elderly individuals. Additionally, Dr. Drebin discusses the role of ablative radiation therapy in local control of pancreatic cancer. [Extracted from the article]

The article discusses urethral obstruction as a potential complication following surgery for stress urinary incontinence in women. It highlights the challenges in diagnosing and treating this condition, emphasizing the importance of timely recognition and intervention. Various surgical techniques, including urethrolysis, are described for addressing iatrogenic bladder outlet obstruction. Patient presentation, evaluation, and postoperative outcomes are also discussed, providing a comprehensive overview of managing this complication. [Extracted from the article]

Objective: To assess applicant opinions regarding program signaling and to understand the effect of 25 signals on interview outcomes during the 2023–2024 otolaryngology residency cycle. Methods: A 36‐item anonymous online survey regarding signaling was sent to applicants who had applied to an otolaryngology residency program at a single institution. Participant demographics, performance in medical school, number of interviews received in relation to signals sent, and applicant perceptions regarding preference signaling were assessed. Results: Eighty‐one applicants participated with a response rate of 30%. Students applied to a median of 64 programs. Approximately 84.4% of interview offers came from programs which the participants signaled. Participants were 5.4 times more likely to get an interview from a program they signaled over programs they did not signal (F = 31.73, p < 0.001). The most common factors that influenced which programs were chosen by candidates were: location (94.9%), departmental reputation (80.8%), and experience on a sub‐internship rotation (69.2%). Overall, 73.0% of participants found signaling helpful and 82.0% agreed that signaling should continue. Conclusion: Understanding the implications of a high‐signaling application process in otolaryngology is crucial. Twenty‐five signals led to 84% of interview offers coming from signaled programs and this was the most important variable associated with interview invitations. Location was the most prevalent factor when deciding where to signal. Signaling was well reviewed by most applicants. Level of Evidence: NA Laryngoscope, 135:80–86, 2025 [ABSTRACT FROM AUTHOR]

The Hospital Italiano de Buenos Aires (HIBA) is one of Argentina's leading healthcare institutions, with an integrated healthcare network of multiple facilities and a university offering comprehensive medical training. Founded in 1854, it has become one of the leading academic medical centers in Latin America. The Department of Plastic, Aesthetic and Reconstructive Surgery founded in 1960, offers a comprehensive residency and fellowship program under the direction of Professor Horacio F. Mayer. With a robust annual caseload of over 1000 surgeries, including complex reconstructive and aesthetic procedures, the department trains residents in a comprehensive curriculum that includes surgical skills, patient care, and research. The three-year structure of the residency program includes progressive responsibilities, rotations in multiple specialties, and hands-on experience with highly complex cases. Residents participate in internal and external education guided by a rigorous evaluation system and multidisciplinary collaboration. The Oncoplastic and Reconstructive Breast Surgery Fellowship continues to refine advanced reconstructive techniques. By promoting research, HIBA's Plastic, Aesthetic and Reconstructive Surgery Program not only meets international standards, but also contributes significantly to the advancement of the field, preparing its graduates for leadership roles nationally and internationally. [ABSTRACT FROM AUTHOR]

Complex liver cancer is often difficult to expose or dissect, and the surgery is often challenging. 3D-printed models may realistically present 3D anatomical structure, which has certain value in planning and training of liver surgery. However, the existing 3D-printed models are all monolithic models, which are difficult to reuse and limited in clinical application. It is also rare to carry fluorescence to accurately present tumor lesions. Here we report reusable fluorescent assembled 3D-printed models to mimic minimally invasive resection of complex liver cancer. Based on the models, multiple copies of liver lesion structure assembled accessories can be printed for the same patient or different patients, ensuring the quantity and quality of simulated surgical training, and greatly reducing the cost of simulated surgical training. The addition of fluorescence is helpful in accurately presenting tumor lesions. The reusable fluorescent assembled 3D-printed models may mimic minimally invasive resection of complex liver cancer, demonstrating potential value in simulated surgery. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Laparoscopic cholecystectomy is one of the most commonly performed surgeries worldwide. With the rise of online platforms like YouTube and WebSurg, surgical videos have become popular educational tools. However, the quality of these videos varies, raising concerns about their reliability. This study evaluates the changes in the quality of laparoscopic cholecystectomy videos over two decades and compares the educational value of YouTube and WebSurg videos.Twenty‐four videos were analyzed and divided into four groups: older YouTube, older WebSurg, newer YouTube, and newer WebSurg. Six videos from each group were selected based on relevance and popularity. Three independent surgeons assessed them using standardized scoring systems, including the JAMA Benchmark Score, Global Quality Score (GQS), LAP‐VEGaS, and a new Laparoscopic Cholecystectomy‐Specific Score (LAP Chole‐SS). Video characteristics such as duration, uploader type, and viewer engagement were also considered. Statistical comparisons were made between the groups.The analysis showed that although newer videos were longer, the difference was not statistically significant (P = 0.74). Newer videos had significantly better image quality (P < 0.001). WebSurg videos consistently outperformed YouTube videos across all evaluation criteria. WebSurg scored higher in the JAMA Benchmark (2.62 versus 1.66), GQS (3.58 versus 2.63), LAP‐VEGaS (13.7 versus 6.58), and LAP Chole‐SS (4.08 versus 2.33).In conclusion, WebSurg provides higher‐quality, peer‐reviewed content, making it more reliable for surgical education, while YouTube offers accessibility but often lacks educational rigor. [ABSTRACT FROM AUTHOR]

Purpose: Gastric cancer (GC) remains a major malignancy. Robotic gastrectomy (RG) has gained popularity due to various advantages. Despite those advantages, many hospitals lack the necessary equipment for RG and are still performing laparoscopic gastrectomy (LG) due to its established minimal invasiveness and safety. Methods: This study assessed the effectiveness of the "Double-Surgeon Technique" (DST) for improving surgical education and proficiency with LG. The DST involves both a console-side surgeon and a patient-side surgeon working actively in RG, enhancing the skill acquisition needed for LG and potentially reducing surgical time. Assessment of this method was performed by surgical time, and cases were divided into three groups: first half (Phase 1: P1) and second half (P2) before the introduction of DST, and after the introduction of DST (P3). Results: Two surgical trainees were trained using the DST. The learning curve in both reached a plateau in P2, but descended again in P3. For one trainee, surgical time for P3 was significantly reduced compared to P1 (p = 0.001) and P2 (p = 0.0027) despite the intervals between laparoscopic distal gastrectomy as the main surgeon in P3 being significantly longer than in P2 (p = 0.0094). Other surgical results in both trainees did not differ significantly. Further, no difference in induction phase results of RG were evident between surgeons and trainees with or without DST experience. Conclusion: Surgical education using the DST could be effective in the current context of the need for RG and LG. [ABSTRACT FROM AUTHOR]

Background: 3D technologies [Virtual and Augmented 3D planning, 3D printing (3DP), Additive Manufacturing (AM)] are rapidly being adopted in the healthcare sector, demonstrating their relevance in personalized medicine and the rapid development of medical devices. The study's purpose was to understand the state and evolution of 3DP/AM technologies at the Point-of-Care (PoC), its adoption, organization and process in Spanish hospitals and to understand and compare the evolution of the models, clinical applications, and challenges in utilizing the technology during the COVID-19 pandemic and beyond. Methods: This was a questionnaire-based qualitative and longitudinal study. Data on 3DP and AM activities in Spain were collected from 73 hospitals/institutions falling under the ITEMAS (Platform for Innovation in Medical and Health Technologies) and the Plataforma ISCIII Biomodelos y Biobancos from January 2019 to May 2020 for the first study, and at the end of 2022 and 2023 for the second study. Results: A total of 23 (31.5%) hospitals during the first study, while 30 (41.09%) during the second study reported having at least one 3DP/AM initiative. Post-covid, the majority of hospitals had onsite 3DP/AM services with a well-defined, structured, and centralized system. Traumatology and maxillofacial surgery services were found to be the most involved in 3DP projects for the production of custom-made surgical guides, prostheses and orthoses. Bioprinting initiatives were also noted to be expanding. Human resources, cost, and regulatory compliance were the key hurdles in introducing 3D/AM in hospitals. Conclusions: In-house 3DP/AM units, with Mixed-Model is the most common model in Spain; The COVID-19 pandemic influenced the 3D planning activity and adoption. Further research and clinical trials, and improvements in resources, reimbursement and regulatory compliance are critical for the Point-of-care hospital growth of this breakthrough technology. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the use of 3D image processing and reconstruction (3D-IPR) combined with virtual reality (VR) technology and printed models (PM) as teaching tools in oncological colorectal surgery. Methods: We designed two courses, one for general surgery trainees and another for young colorectal surgeons, structured around stations of pre-test, anatomical lessons, real-case presentations, 3D-IPR models, VR experiences, and life-size abdominal PM with surgical approach explanations and a final post-test. Results: Fourteen course participants were evaluated. Pre-test scores averaged 5.15, with a median of 5.5, while post-test scores increased to an average of 7.75, with a median score of 8. Course satisfaction surveys indicated high ratings for expectations, duration, relevance, presenter knowledge, teaching materials, communication, and overall course segments, with an average rating exceeding 4.8 out of 5. Results highlight the potential of 3D-IPR, VR, and PM as tools for improving teaching for surgery residents and colorectal surgeons. These technologies offer immersive, risk-free experiences for learners, potentially enhancing skill acquisition and anatomical understanding. Conclusion: This study demonstrates the effectiveness of 3D-IPR, VR, and PM courses in improving understanding of colorectal surgery. As these technologies continue to advance, they offer enhanced immersion and accessibility, transforming surgical education and medical training. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Simulation training has become part of medical student education, however endoscopy simulators have mostly been reserved for speciality training. Evidence suggests that simulation training has the potential to educate future doctors about endoscopy procedures and improve their communication with patients. Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic procedure that is technically challenging and poorly understood by medical students. This study aimed to investigate whether simulating gastroscopy and ERCP using an anatomical model of the upper gastrointestinal tract improves procedural knowledge, confidence, and performance in medical students.Students completed three attempts at gastroscopy and one attempt at ERCP using the model. Participants rated knowledge and confidence relating to endoscopic procedures before and after completing the simulation. Students also reported their attitudes towards endoscopic simulation training after their participation.There was a significant increase in self‐perceived knowledge of the purpose of and steps involved in endoscopy (P < 0.001), gastrointestinal anatomy (P = 0.003), and biliary system anatomy (P = 0.002) after using the simulator. Participants also reported significantly increased skills confidence in performing gastroscopy and duodenoscopy (P < 0.001), including in their ability to explain endoscopic procedures to a patient (P < 0.001). All participants agreed (5%) or strongly agreed (95%) that simulation training is a useful addition to their learning, and that they would like more simulation training in the medical curriculum.Simulation training is an effective and engaging method of promoting procedural awareness and understanding of basic endoscopic procedures in medical students, with the potential to improve doctor–patient interactions in early clinical practice. [ABSTRACT FROM AUTHOR]

Background Method Results Conclusion Rural general surgeons require a diverse skillset to manage the varied work required in regional settings. Access to appropriate surgical services is important but challenging due to a lack of resident rural surgeons and increasing surgical subspecialisation.This is a retrospective multi‐centre study on procedures undertaken within the General Surgery departments of two regional centres in Western Australia; Albany Health Campus (AHC) and Bunbury Regional Hospital (BRH). Data was extracted from theatre management system reports from 2019 to 2023.A total of 18 140 and 21 971 procedures were performed at AHC and BRH, respectively. Endoscopic work formed 56.5% of procedural work. Both sites demonstrated significant numbers of general surgical subspecialty procedures, particularly in colorectal and upper gastrointestinal/hepatobiliary surgery. However, the scope of non‐general surgical procedures undertaken by the general surgery teams showed a considerable difference, with 35% of operative procedures at AHC and 14% at BRH falling within other surgical specialty areas, primarily plastic surgery, urology, and vascular surgery. Finally, close to 5% of procedures at each site were on paediatric patients.This study documents the varied caseload undertaken by rural general surgeons in Western Australia. It highlights that general surgeons must be exposed to a broad spectrum of procedures to work in regional settings once qualified and discusses novel programs designed to equip rural surgical candidates with the skills required to manage the caseload. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion There is limited published data on the caseload of general surgeons in Central Australia. The region has a significant Indigenous population, who often face higher rates of chronic diseases and require more frequent surgical interventions compared to non‐Indigenous individuals. This study aims to outline the workload of surgeons at Alice Springs Hospital to determine the necessary skill set and surgical education for future surgeons.A retrospective review of all general surgery operative cases performed in Central Australia, Alice Springs Hospital was conducted between January 2012 and December 2021. The RACS Morbidity Audit and Logbook Tool was used to classify surgical procedures along with Medicare Benefits Schedule item numbers. Tables were created to present the annual and specialty‐specific data on the types and volumes of procedures.From January 2012 to December 2021, 35 318 cases were performed, with 92.5% being general surgery, 3% plastics and reconstructive surgery and 2.8% vascular procedures. Indigenous patients received a higher proportion of procedures (50–60%) compared to non‐Indigenous patients (30–50%). Common procedures included incision and drainage of abscesses and debridement of wounds, while trends across specialties showed a decline in ENT and plastic surgeries, stable thoracic and vascular cases, and increased numbers of urology operations.General surgeons in rural centres must possess a wide range of skills and be capable of performing a variety of procedures. Trainees should be encouraged to consider practicing in rural areas, and those interested should account for the specific needs of the communities they plan to serve. [ABSTRACT FROM AUTHOR]

AbstractBackgroundObjectivesMaterials and methodsResultsConclusions and significanceOptimizing the educational experience of trainees in the operating room is important; however, ear anatomy and otologic surgery are challenging for trainees to grasp. Viewing otologic surgeries often involves limitations related to video quality, such as visual disturbances and instability.We aimed to (1) improve the quality of surgical videos (tympanomastoidectomy [TM]) by using artificial intelligence (AI) techniques and (2) evaluate the effectiveness of processed videos through a questionnaire-based assessment from trainees.We conducted prospective study using video inpainting and stabilization techniques processed by AI. In each study set, we enrolled 21 trainees and asked them to watch processed videos and complete a questionnaire.Surgical videos with the video inpainting technique using the implicit neural representation (INR) model were found to be the most helpful for medical students (0.79 ± 0.58) in identifying bleeding focus. Videos with the stabilization technique via point feature matching were more helpful for low-grade residents (0.91 ± 0.12) and medical students (0.78 ± 0.35) in enhancing overall visibility and understanding surgical procedures.Surgical videos using video inpainting and stabilization techniques with AI were beneficial for educating trainees, especially participants with less anatomical knowledge and surgical experience. [ABSTRACT FROM AUTHOR]

Up to 80% of the world's population with epilepsy lives in low and middle‐income countries. Around one‐third of these patients will have drug‐resistant epilepsy, for which epilepsy surgery is an option. Unfortunately, many of these regions, as well as some more developed nations, lack sufficient epilepsy surgery units and trained neurosurgeons. With this in mind, the International League Against Epilepsy (ILAE) formed the Epilepsy Surgery Education Taskforce to address the shortage of further educational opportunities for surgeons and neurologists and to promote the creation of more epilepsy surgery units around the world. In this article, we publish our findings from a web‐based international survey, in which we investigated the global distribution and experience of neurosurgeons who perform epilepsy surgery, their educational paths, and opinions on the further need for epilepsy surgery education, as well as the resources available to them. We report a detailed analysis of the 202 survey replies received from 35 different countries across six continents. The lack of adequate numbers of epilepsy surgery units in the Southern Hemisphere is notable, and the aim of this task force with other ILAE committees, is to improve access to epilepsy surgery for patients and to enhance training for their health care providers. [ABSTRACT FROM AUTHOR]

Background: Extended reality (XR) technologies which include virtual, augmented, and mixed reality have significant potential in surgical training, because they can help to eliminate the limitations of traditional methods. This umbrella review aimed to investigate factors that influence the acceptance and use of XR in surgical training using the unified theory of acceptance and use of technology (UTAUT) model. Methods: An umbrella review was conducted in 2024 by searching various databases until the end of 2023. Studies were selected based on the predefined eligibility criteria and analyzed using the components of the UTAUT model. The quality and risk of bias of the selected studies were assessed, and the findings were reported descriptively. Results: A total of 44 articles were included in this study. In most studies, XR technologies were used for surgical training of orthopedics, neurology, and laparoscopy. Based on the UTAUT model, the findings indicated that XR technologies improved surgical skills and procedural accuracy while simultaneously reducing risks and operating room time (performance expectancy). In terms of effort expectancy, user-friendly systems were accessible for the trainees with various levels of expertise. From a social influence standpoint, XR technologies enhanced learning by providing positive feedback from experienced surgeons during surgical training. In addition, facilitating conditions emphasized the importance of resource availability and addressing technical and financial limitations to maximize the effectiveness of XR technologies in surgical training. Conclusions: XR technologies significantly improve surgical training by increasing skills and procedural accuracy. Although adoption is facilitated by designing user-friendly interfaces and positive social influences, financial and resource challenges must be overcome, too. The successful integration of XR into surgical training necessitates careful curriculum design and resource allocation. Future research should focus on overcoming these barriers, so that XR can fully realize its potential in surgical training. [ABSTRACT FROM AUTHOR]

The combination of hydronephrosis formation, ureteroscopic imaging, and ultrasound delineation has not been included in any non-biological training model of percutaneous nephrolithotomy or endoscopic combined intrarenal surgery. We aimed to develop a realistic kidney phantom using the self-healing properties of supramolecular hydrogels for percutaneous nephrolithotomy and endoscopic combined intrarenal surgery and evaluate its suitability as a training model.Expert and resident urologists performed ultrasound-guided renal pelvic punctures and flexible ureteroscopies for endoscopic combined intrarenal surgery using a training model. Subsequently, the training model was evaluated using a 17-item Likert scale questionnaire (range, 1–5 points). After being filled with carrageenan, the collecting system was inflated, and the relationship between the collecting system volume and collecting system pressure was determined. The durability of the model was verified by repeatedly inserting a 16-Fr access sheath. Five novices and seven urology experts performed the procedure. The mean questionnaire score was 4.25 (standard deviation, 0.37). The model was able to hold 50 mL of air, and the pressure in the collecting system ranged from 6 to 33 mmHg. Repeated punctures were possible even when a 16-Fr access sheath was inserted. Our new training model included the self-healing properties of supramolecular hydrogels, which are tough and flexible and can be evaluated using ultrasonography. According to the questionnaire score, the model was highly satisfactory and has potential as a new educational tool. [ABSTRACT FROM AUTHOR]

Recently artificial intelligence (AI) platforms have developed at a rapid pace. To date no studies have explored AI platform ChatGPT's ability to serve as an aid in research in the field of otolaryngology. The objective of our study is to evaluate the ability of ChatGPT to generate unique research ideas relevant to Otolaryngology. ChatGPT was tasked to generate novel research project ideas. Seven categories for all otolaryngology subspecialties were created: general otolaryngology, facial plastics and reconstructive surgery, rhinology and skull base surgery, pediatrics, head and neck oncology, laryngology, and otology/neurotology. Within each of the subspecialties, ChatGPT was prompted to provide research ideas for two specific research topics in order to gauge ChatGPT's ability to explore specific domains. Ten prompts were entered for general otolaryngology, and five prompts were entered for each subspecialty and subspecialty topic. ChatGPT was subsequently prompted with the same query to generate systematic review ideas for each category. Ideas were deemed novel if there were no similar systematic reviews retrieved during the literature review on PubMed, Scopus, or Web of Science. Ideas were graded for Clinical Relevance on a scale of 0 to 5, 5 being considered highly relevant/would contribute greatly to patient care and 0 being considered not relevant/not beneficial to patient care. Two reviewers graded each response. Out of 100 systematic review ideas generated by ChatGPT, we found that the artificial intelligence platform was incapable of creating unique systematic review research ideas. However, the ideas that it did generate were largely feasible and clinically relevant. Future studies should investigate the ability of ChatGPT to generate research inquiries with non-systematic review methodologies and in more specific otolaryngology topics. [ABSTRACT FROM AUTHOR]