Search

PURPOSE: To assess outcomes of Descemet stripping endothelial keratoplasty (DSEK) in eyes with custom artificial iris (CAI) implantation. METHODS: This is a retrospective, interventional, consecutive, surgical case series of patients who underwent DSEK after CAI implantation between 2010 and 2021 at 2 referral centers. Primary safety measures were loss of corrected distance visual acuity (CDVA), increase in intraocular pressure (IOP), development or progression of glaucoma, and intraoperative and postoperative complications. Efficacy measures were graft survival at year 1 and improvement in cosmesis at postoperative month 3. In general, measures were compared between baseline and postoperative year 1 while any complication was reported for the full follow-up period. RESULTS: Thirty-nine eyes of 39 patients were identified. 64.1% of eyes had acquired aniridia from trauma. The mean follow-up interval was 27.7 months (range 12.2-117.4). Median CDVA improved from logMAR 1.0 to 0.7 at year 1 ( P = 0.0047). At the final follow-up, permanent loss of CDVA occurred in 25.6% of eyes, of which 90% was due to glaucoma. The most common postoperative complication was IOP elevation (66.7% of eyes). Graft survival at postoperative year 1 was 82.0% (95% confidence interval, 66.3-91.4). Secondary graft failure occurred in 28.2% of eyes at a mean duration of 39.7 months (SD 27.9 months) after DSEK. Cosmesis improved among 87.2% of eyes at postoperative month 3. CONCLUSIONS: DSEK is an effective procedure for addressing corneal edema in eyes with a CAI, but a majority develop elevated IOP and graft survival is shorter than in eyes without a CAI.

Purpose: To perform a systematic review (SR) to examine the application of classification systems (CS) used to report intraoperative adverse events (iAEs) in urological surgery and to evaluate the crude incidence and type of iAEs. Materials and methods: This review was published via PROSPERO (CRD42024549954) and conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). MEDLINE, Embase, and the Cochrane CENTRAL were searched using a predefined PICO framework: (P) patients with benign and malignant urological diseases, (I) all types of urological surgery, (C) none/any, (O) intraoperative complications classified with grading systems. Retrospective and prospective studies published between January 2019 and June 2024 were included. Results: The search yielded 1,570 abstracts, 1,043 full-text articles were assessed for eligibility, of which 325 studies reported iAEs (54 used iAE-CS, 64 used Clavien-Dindo Classification and 207 used free-text descriptions). Of the 54 studies (15,298 patients) that used an iAE-CS, the three most used systems were the EAUiaiC (54%), SATAVA (26%), and the modified SATAVA (7%). The overall incidence of iAE was 14% (2,153/15,225 patients). On a study level, the crude incidence of iAE was between 0 and 100% (median 7%, IQR: 3-13%). The misapplication of the Clavien-Dindo system to describe iAEs was high (n = 64 studies). Conclusions: The use of iAE-CS is scarce, and there is a lack of universal consensus on a CS to describe iAEs. iAE are poorly reported in urological studies. Urologists should report all perioperative complications to improve transparency and surgical and hospital processes. [ABSTRACT FROM AUTHOR]

Purpose: To assess the possibility of anterior segment optical coherence tomography (AS-OCT)-based preoperative evaluation of the lens in order to prevent and predict intraoperative complications of posterior subcapsular cataract (PSC) surgery. Methods: This prospective study included 512 eyes diagnosed with PSC. AS-OCT was performed using Line, Cross Line and 3D Cornea scans to visualize the posterior capsule. The posterior capsule and opacities in the subcortical and cortical lens, their relationship and the state of the retrolenticular space were assessed. The study sample was divided into three groups while taking into account the revealed morphological changes in the lens. Groups 1, 2, and 3 comprised 312, 185 and 15 eyes, respectively, with each group characterized by a specific type (1, 2 or 3) of morphological AS-OCT changes in the PSC. Surgery consisted of ultrasound phacoemulsification with intraocular lens implantation. Well-known measures related to cataract surgery stages were performed, if required, to preserve the integrity of the posterior capsule, while taking into account the type of PSC changes. We preoperatively determined the eyes at risk for intraoperative posterior capsular rupture (PCR) and detection of posterior capsular plaque (PCP), and compared this data with the postoperative data on the state of the posterior capsule. Results: The PSC cases with an expected rate of intraoperative complications of 0 to 10% were classified as those with a low risk, whereas the rest, with a high risk of complications. Only eyes with type 2 or type 3 PSC changes were expected to have a high risk of intraoperative PCP, and only eyes with type 3 PSC changes, a high risk of PCR. In groups 1, 2 and 3, the rates of intraoperative PCP were 0%, 100% and 46.7%, respectively, and the rates of intraoperative PCR, 0%, 0% and 53.3%, respectively. There was a significant positive correlation between preoperative OCT-based morphology of the lens and intraoperative complications (r = 0.88, p ≤0.001). Sensitivity and specificity for the method of AS-OCT-based evaluation of risks of intraoperative complications in PSC surgery were 98.8% and 96.5%, respectively. Conclusion: AS-OCT allows evaluating preoperatively posterior lens opacification morphology and posterior capsular changes, determining the risks of complications, and performing surgical planning for PSC. Key messages: What is Known? Complications (posterior capsule (PC) rupture with or without vitreous loss and residual PC plaque) are common in, and affect the expected outcome of, posterior subcapsular cataract (PSC) surgery. What is new? PC plaque is most likely in eyes with preoperative type 2 changes in the PSC, whereas eyes with preoperative type 3 changes are likely to show PC rupture or residual PC plaque. AS-OCT enables an experienced surgeon to predict the risks of intraoperative complications in, and perform surgical planning for, PSC surgery. [ABSTRACT FROM AUTHOR]

Background: Frailty is increasingly being recognized as a risk factor for adverse outcomes in older surgical patients undergoing surgery. We investigated the association between frailty and intraoperative complications using multiple frailty assessment tools in older patients undergoing elective intermediate- to high-risk non-cardiac surgery. Methods: This retrospective cohort study included 637 older patients scheduled for elective non-cardiac surgery. Frailty was assessed using the Clinical Frailty Scale (CFS), FRAIL scale, and modified Frailty Index-11 (mFI-11). The predictive ability of frailty tools was analyzed and compared using the area under the receiver operating characteristic curve (AUC). Results: Frailty was significantly associated with higher intraoperative complication rates (FRAIL scale: p = 0.01; mFI-11: p = 0.046). Patients considered frail using the mFI-11 were more likely to have unplanned intensive care unit admissions (p < 0.001). Those classified as frail by the FRAIL scale and mFI-11 had significantly higher rates of vasopressor/inotrope use (p = 0.001 and p = 0.005, respectively) and mechanical ventilation (p = 0.033 and p = 0.007, respectively). In the univariate analysis, frailty measured using the FRAIL scale was significantly associated with intraoperative complications (odds ratio [OR], 2.41; 95% confidence interval [CI]: 1.33–4.38; p = 0.004); this association was not significant in the multivariate analysis (adjusted OR, 1.69; 95% CI: 0.83–3.43; p = 0.148; AUC = 0.550). Atrial fibrillation, hemoglobin levels, anesthesia type, and surgical subspecialty were stronger predictors of intraoperative complications. Conclusions: Frailty assessments demonstrate the limited predictive ability for intraoperative complications. Specific comorbidities, surgical techniques, and anesthesia types play more critical roles. Comprehensive preoperative evaluations integrating frailty with broader risk stratification methods are necessary to enhance patient outcomes and ensure safety. [ABSTRACT FROM AUTHOR]

Background: A broken bur retained in the lower jaw is an uncommon complication that occurs during the extraction of the impacted mandibular third molar. The purpose of this retrospective study was to investigate the clinical characteristics of the broken burs and review our experience with the removal of the broken burs in these cases. Methods: All patients, who suffered the broken bur remained in the lower jaw due to the extraction of the impacted mandibular third molar and presented to our hospital from July 2019 to July 2024, were included in this retrospective study. Demographic information of these cases was analyzed by descriptive statistics and the treatment methods were summarized. Results: Based on the location of the broken burs, these cases can be classified into three types: (1) in the mandible; (2) between the lingual alveolar bone and periosteum; and (3) in the soft tissue of the mouth floor. In the cases of type 1, the removal of the broken burs was assisted by a tooth-supported digital guiding plate that precisely located the broken bur. The localization of the broken burs in types 2 and 3 was based on the preoperative radiographs, and the removal of the broken burs in the two types was mainly dependent on the surgeons' experience. All the broken burs were successfully removed, and all patients displayed uneventful healing. Conclusions: The broken burs remained in the lower jaw due to the extraction of the impacted mandibular third molar assumes many forms. The key point for the successful removal of the broken burs is to choose the corresponding methods based on the location of the broken burs. [ABSTRACT FROM AUTHOR]

Background: This study aimed to establish a model for predicting the difficulty of mandibular third molar extraction based on a Bayesian network to meet following requirements: (1) analyse the interaction of the primary risk factors; (2) output quantitative difficulty-evaluation results based on the patient's personal situation; and (3) identify key surgical points and propose surgical protocols to decrease complications. Methods: Relevant articles were searched to identify risk factors. Clinical knowledge and experience were used to analyse the risk factors to establish the Bayesian network. First, the qualitative mechanism knowledge, including the effect of risk factors on the extraction difficulty and the causal relationships between risk factors, was analysed to establish the framework of the Bayesian network. Then, the quantitative knowledge, including the occurrence probability of the parent nodes and the conditional probability table of the nodes with causal relationships, was given by the surgeon experience and calculated using the Dempster-Shafer evidence theory. According to the framework and likelihoods and relationships of risk factors, the Bayesian network model was established. Results: This Bayesian network model analysed the weight by sensitivity of each risk factor and expressed the interaction relationship among risk factors as well as the effect of risk factors on extraction difficulty quantitatively. This Bayesian network model showed quantitative analysis results for extraction difficulty and key risk factors. The Bayesian network model revealed that the relationship to the inferior alveolar nerve, surgeon experience and patient anxiety were the most important risk factors for extraction difficulty. By integrating these patient-specific risk factors across the entire surgical process, this model could be used during preoperative planning to identify high-risk cases and to optimize resource allocation; during intraoperative management to tailor surgical techniques; and during postoperative follow-up to establish targeted follow-up protocols for high-risk patients. Moreover, this Bayesian network model can flexibly improve inclusion factors and conditional probabilities with the development of relevant research and expert opinions, as well as change states and probabilities of relevant nodes based on actual clinical conditions. Conclusions: A model for predicting the difficulty of mandibular third molar extraction was established based on a Bayesian network. [ABSTRACT FROM AUTHOR]

Implant removal is a common surgical procedure, but it is associated with various intraoperative and postoperative challenges. This prospective observational study aimed to investigate the epidemiology of problems faced during and after orthopedic implant removal surgeries. This single-center study included 70 participants who underwent orthopedic implant removal. Intraoperative and postoperative complications were recorded, and risk factors were analyzed using univariate and multivariate analyses. The most common type of implant removed was Femur and Tibia Nails accounting for 14.2% of cases (n=10), followed by TENS (at 14.2%; n=10), K wires & CC Screws (at 12.8%; n=9), Proximal tibia fracture (at 11.4%; n=8), TBW in Patellar Fracture (at 10.0%; n=7), Clavicle Fracture (at 10.0%; n=7), DER Plates in Distal Radius Fracture (at 8.57%; n=6), CC screws & fibular plates in bimalleolar fractures (at 8.57%; n=6), 3.5 DCP in both bone forearm fracture (at 7.14%; n=5) and DHS in IT Fracture (at 4.28%; n=3). Intraoperative complications were reported in 35.7% of cases, with the most frequent being difficulty in implant extraction (34.3%), extensive tissue dissection (21.4%), and the need for additional surgical interventions (17.1%). Postoperative complications occurred in 62.9% of the cohort, including wound healing issues (30%), infections (21.4%), and hematoma formation (20%). Osteoporosis, longer duration of implantation, obesity, and chronic pain syndrome were identified as significant risk factors for intraoperative complications. Age, diabetes, and longer surgical duration were associated with an increased risk of postoperative complications. This study provides comprehensive insights into the epidemiology of problems faced intraoperatively and postoperatively during orthopedic implant removal procedures. The findings highlight the significant incidence of complications and the importance of risk stratification and individualized management strategies to optimize patient outcomes. [ABSTRACT FROM AUTHOR]

In recent years, the emergence and application of robotic computer-assisted implant surgery (r-CAIS) has resulted in a revolutionary shift in conventional implant diagnosis and treatment. This scoping review was performed to verify the null hypothesis that r-CAIS has a relatively high accuracy of within 1 mm, with relatively few complications and a short operative time. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). From the 3355 publications identified in the PubMed, Scopus, Web of Science, and Google Scholar databases, 28 were finally included after a comprehensive review and analysis. The null hypothesis is partly accepted, as r-CAIS has a relatively high accuracy (coronal and apical deviation within 1 mm), and no significant adverse events or complications have been reported to date, although additional confirmatory studies are needed. However, there is insufficient evidence for a shorter surgical time, and further clinical research on this topic is required. [ABSTRACT FROM AUTHOR]

Abstract Background A broken bur retained in the lower jaw is an uncommon complication that occurs during the extraction of the impacted mandibular third molar. The purpose of this retrospective study was to investigate the clinical characteristics of the broken burs and review our experience with the removal of the broken burs in these cases. Methods All patients, who suffered the broken bur remained in the lower jaw due to the extraction of the impacted mandibular third molar and presented to our hospital from July 2019 to July 2024, were included in this retrospective study. Demographic information of these cases was analyzed by descriptive statistics and the treatment methods were summarized. Results Based on the location of the broken burs, these cases can be classified into three types: (1) in the mandible; (2) between the lingual alveolar bone and periosteum; and (3) in the soft tissue of the mouth floor. In the cases of type 1, the removal of the broken burs was assisted by a tooth-supported digital guiding plate that precisely located the broken bur. The localization of the broken burs in types 2 and 3 was based on the preoperative radiographs, and the removal of the broken burs in the two types was mainly dependent on the surgeons’ experience. All the broken burs were successfully removed, and all patients displayed uneventful healing. Conclusions The broken burs remained in the lower jaw due to the extraction of the impacted mandibular third molar assumes many forms. The key point for the successful removal of the broken burs is to choose the corresponding methods based on the location of the broken burs.

Abstract Background This study aimed to establish a model for predicting the difficulty of mandibular third molar extraction based on a Bayesian network to meet following requirements: (1) analyse the interaction of the primary risk factors; (2) output quantitative difficulty-evaluation results based on the patient’s personal situation; and (3) identify key surgical points and propose surgical protocols to decrease complications. Methods Relevant articles were searched to identify risk factors. Clinical knowledge and experience were used to analyse the risk factors to establish the Bayesian network. First, the qualitative mechanism knowledge, including the effect of risk factors on the extraction difficulty and the causal relationships between risk factors, was analysed to establish the framework of the Bayesian network. Then, the quantitative knowledge, including the occurrence probability of the parent nodes and the conditional probability table of the nodes with causal relationships, was given by the surgeon experience and calculated using the Dempster-Shafer evidence theory. According to the framework and likelihoods and relationships of risk factors, the Bayesian network model was established. Results This Bayesian network model analysed the weight by sensitivity of each risk factor and expressed the interaction relationship among risk factors as well as the effect of risk factors on extraction difficulty quantitatively. This Bayesian network model showed quantitative analysis results for extraction difficulty and key risk factors. The Bayesian network model revealed that the relationship to the inferior alveolar nerve, surgeon experience and patient anxiety were the most important risk factors for extraction difficulty. By integrating these patient-specific risk factors across the entire surgical process, this model could be used during preoperative planning to identify high-risk cases and to optimize resource allocation; during intraoperative management to tailor surgical techniques; and during postoperative follow-up to establish targeted follow-up protocols for high-risk patients. Moreover, this Bayesian network model can flexibly improve inclusion factors and conditional probabilities with the development of relevant research and expert opinions, as well as change states and probabilities of relevant nodes based on actual clinical conditions. Conclusions A model for predicting the difficulty of mandibular third molar extraction was established based on a Bayesian network.

Abstract Background Management of RCC with IVC thrombus can be surgically challenging, particularly when the tumour thrombus extends above the diaphragm. Cardiopulmonary bypass is often employed to aid surgical removal of the tumour in such cases. Case presentation We detail an instance of 67-year-old Male patient suffering from RCC with IVC thrombus, with the tumour thrombus extending into the right atrium, who developed on-table retrograde type A aortic dissection amidst the surgical procedure, thereby precluding cardiopulmonary bypass. Transfixation of the renal arterial stump resulted in disappearance of the dissection flap. Conclusions Operating surgeons should be mindful of the potential for retrograde aortic dissection during Radical Nephrectomy and its implications intraoperatively.

Objective To analyze the complications occurring during the induction, maintenance, and recovery phases of anesthesia and the perioperative period in neonates and infants undergoing emergency gastrointestinal surgery. Methods A retrospective analysis was conducted on the clinical data of 196 neonates and infants who underwent surgery for acute abdomen at our hospital. These patients were divided into neonatal group (group N, age ≤30 days, 115 cases) and infant group (group I, age 30 days to 6 months, 81 cases). Data on general information, disease distribution, and intraoperative and postoperative complications were collected for both groups. Results There were significant differences between the two groups in body mass (t =-8.517,P

Aims: The Bankart and Latarjet procedures are two of the most common surgical techniques to treat anterior shoulder instability with satisfactory clinical and functional outcomes. However, the outcomes in the adolescent population remain unclear, and there is no information regarding the arthroscopic Latarjet in this population. The purpose of this study was to evaluate the outcomes of the arthroscopic Bankart and arthroscopic Latarjet procedures in the management of anterior shoulder instability in adolescents. Methods: We present a retrospective, matched-pair study of teenagers with anterior glenohumeral instability treated with an arthroscopic Bankart repair (ABR) or an arthroscopic Latarjet (AL) procedure with a minimum two-year follow-up. Preoperative demographic and clinical features, factors associated with dislocation, and complications were collected. Recurrence, defined as dislocation or subluxation, was established as the primary outcome. Clinical and functional outcomes were analyzed using objective (Rowe), and subjective (Western Ontario Shoulder Instability Index (WOSI) and Single Assessment Numeric Evaluation (SANE)) scores. Additionally, the rate of return to sport was assessed. Results: A total of 51 adolescents were included, of whom 46 (92%) were male, with 17 (33%) in the Latarjet group and 34 (66%) in the Bankart group. The mean age at time of surgery was 18 years (15 to 19). There were no intraoperative complications. At a median follow-up of nine years (IQR 2 to 18), recurrence was observed in 12 patients in the Bankart group (35.3%) and one patient in the Latarjet group (5.9%) (p = 0.023). Satisfactory postoperative outcomes were obtained, with mean Rowe, WOSI, and SANE scores noted at 95 (10 to 100), 325 (25 to 1,975), and 87.5 (10 to 100), respectively. Most patients (29 in the Bankart group (85.3%) and 16 in the Latarjet group (94.1%)) were able to return to sport (p = 0.452). Conclusion: The ABR and AL procedures both obtain satisfactory clinical and functional outcomes in the treatment of anterior glenohumeral instability in adolescents with a low complication rate. However, the ABR is associated with a significantly higher recurrence rate. Cite this article: Bone Jt Open 2024;5(11):1041–1048.

Abstract Background Postoperative negative pressure pulmonary edema (NPPE) can occur in any patient undergoing general anesthesia. There are several risk factors for it, especially postoperative laryngospasm. The disease is usually benign and quickly reversible. In our case the severity and need for advanced critical care therapy was unusual. Case We report a severe case of postoperative negative pressure pulmonary edema in a 62-year-old male patient undergoing elective right-sided retroperitoneoscopic adrenalectomy. The patient developed a severe case of acute respiratory distress syndrome (ARDS) after postoperative laryngospasm, possibly in conjunction with a suspected anaphylactic reaction. The patient was consequently treated with a combination of invasive airway pressure release ventilation (APRV) and a prone positioning regimen. After drastic improvement in respiratory function, the patient was discharged from the intensive care unit after 10 days and from the hospital after 14 days. Conclusion NPPE is a rare but relevant complication of anesthesia and laryngospasm. The disease can basically occur in any patient undergoing general anesthesia and therefore should be considered.

Background/Objectives: Surgical procedures carry inherent risks, including injuries from surgical positioning, which impact patient safety and healthcare quality. An instrument to assess and prevent these injuries is essential. This study aimed to validate and culturally adapt the ELPO-PT for the Portuguese population to ensure its applicability and effectiveness in assessing the risk of injury from surgical positioning. Methods: A validation study was conducted with 126 adult patients undergoing surgical procedures at a central hospital in northern Portugal. Statistical analyses, including the calculation of Cronbach’s alpha coefficient, assessed the internal reliability of the scale. Additionally, sensitivity and specificity analyses evaluated the ELPO-PT’s diagnostic accuracy in identifying patients at risk of developing positioning-related injuries. Results: The validation showed a Cronbach’s alpha coefficient of 0.782, indicating reasonable internal reliability. Sensitivity analysis revealed an 85% accuracy rate in identifying patients at risk of positioning injuries, while specificity analysis demonstrated a 90% accuracy rate for patients not at risk. Conclusions: The ELPO-PT is a valid and reliable instrument for aiding nurses in clinical decision-making, with significant sensitivity and specificity in identifying the risk of positioning-related injuries, including pressure ulcers, in adult patients during the intraoperative period. Its implementation is expected to be beneficial in healthcare settings, contributing to the prevention of complications associated with surgical positioning.

Introduction: Preoperative fasting is a standard practice aimed at minimising the risk of pulmonary aspiration during surgery. However, patients often experience prolonged fasting periods beyond the recommended duration due to unanticipated delays in the operating theatre, communication failures between teams, inadequate preoperative planning and other factors. Aim: To investigate the effects of unexpectedly prolonged fasting on intraoperative and postoperative parameters in patients undergoing elective surgery under spinal anaesthesia. Materials and Methods: This prospective observational study was conducted from October 2023 to June 2024 at the Department of Anaesthesiology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India. The study included 70 patients undergoing elective surgery under spinal anaesthesia. Patients were divided into two groups: Group A (AM group, n=35), scheduled for surgery between 8:00 AM and 12:00 PM and Group B (PM group, n=35), scheduled for surgery after 12:00 PM or with delayed surgeries. Intraoperative parameters, including Mean Arterial Pressure (MAP), Heart Rate (HR), oxygen saturation (SpO2) and random blood glucose levels, were recorded at specific time points. Postoperative outcomes, such as nausea, vomiting and random blood glucose levels, were also assessed. Continuous and discrete variables were summarised as mean±SD and median, while categorical variables were presented as frequencies and percentages. Associations between categorical variables were tested using Pearson’s Chi-square or Fisher’s-exact test, with p-values

Objectives Patients and Methods Results Conclusion To evaluate the pre‐ and intraoperative variables that impact the integrity of the corporal bodies over time after inflatable penile prosthesis (IPP) placement, as predictors of intraoperative corporal perforation and delayed cylinder complications have not been well characterized.We retrospectively reviewed a 16‐centre multi‐institutional database of IPP surgeries performed by experienced implanters from 2016 to 2021. Poor corporal integrity (PCI) was defined as intraoperative (iPCI) corporal complications or postoperative (pPCI) corporal complications. Multivariable analysis was performed to identify independent predictors of PCI, iPCI, and pPCI. Primary outcomes included intra‐ and postoperative corporal complications.We identified 5153 patients for analysis from 5406 IPP cases, finding 152 (2.95%) cases of PCI. On multivariable analysis, predictors of PCI included revision IPP surgery (odds ratio [OR] 8.16, 95% confidence interval [CI] 5.15–12.92; P < 0.001), sequential dilatation (OR 2.12, 95% CI 1.32–3.39; P = 0.002), coronary artery disease (CAD)/peripheral vascular disease (PVD) (OR 1.81, 95% CI 1.18–2.77; P = 0.006), older age (OR 1.02, 95% CI 1.01–1.04; P = 0.013), and corporal scarring (OR 1.58, 95% CI 1.0–2.5; P = 0.049). Predictors of iPCI included revision IPP surgery (OR 7.34, 95% CI 4.18–12.88; P < 0.001), corporal scarring (OR 2.77, 95% CI 1.64–4.69; P < 0.001), radiation therapy (OR 2.25, 95% CI 1.0–5.04; P = 0.049), and older age (OR 1.03, 95% CI 1.0–1.05; P = 0.025). Revision IPP surgery (OR 7.92, 95% CI 3.69–17.01; P < 0.001), sequential dilatation (OR 3.4, 95% CI 1.61–7.19; P = 0.001), CAD/PVD (OR 2.98, 95% CI 1.56–5.72; P = 0.001), and history of priapism (OR 3.59, 95% CI 1.08–11.99; P = 0.038) were predictive of pPCI.Coronary artery disease/PVD, being of older age, having corporal scarring, undergoing IPP revision surgery and sequential dilatation were predictive risk factors for complications associated with PCI. Identifying patients who are at risk of having PCI may improve patient‐specific counselling, consideration of referral to more experienced implanters, and surgical planning to potentially promote longer‐term device viability. [ABSTRACT FROM AUTHOR]

Background: Management of RCC with IVC thrombus can be surgically challenging, particularly when the tumour thrombus extends above the diaphragm. Cardiopulmonary bypass is often employed to aid surgical removal of the tumour in such cases. Case presentation: We detail an instance of 67-year-old Male patient suffering from RCC with IVC thrombus, with the tumour thrombus extending into the right atrium, who developed on-table retrograde type A aortic dissection amidst the surgical procedure, thereby precluding cardiopulmonary bypass. Transfixation of the renal arterial stump resulted in disappearance of the dissection flap. Conclusions: Operating surgeons should be mindful of the potential for retrograde aortic dissection during Radical Nephrectomy and its implications intraoperatively. [ABSTRACT FROM AUTHOR]

Background/Objectives: Surgical procedures carry inherent risks, including injuries from surgical positioning, which impact patient safety and healthcare quality. An instrument to assess and prevent these injuries is essential. This study aimed to validate and culturally adapt the ELPO-PT for the Portuguese population to ensure its applicability and effectiveness in assessing the risk of injury from surgical positioning. Methods: A validation study was conducted with 126 adult patients undergoing surgical procedures at a central hospital in northern Portugal. Statistical analyses, including the calculation of Cronbach's alpha coefficient, assessed the internal reliability of the scale. Additionally, sensitivity and specificity analyses evaluated the ELPO-PT's diagnostic accuracy in identifying patients at risk of developing positioning-related injuries. Results: The validation showed a Cronbach's alpha coefficient of 0.782, indicating reasonable internal reliability. Sensitivity analysis revealed an 85% accuracy rate in identifying patients at risk of positioning injuries, while specificity analysis demonstrated a 90% accuracy rate for patients not at risk. Conclusions: The ELPO-PT is a valid and reliable instrument for aiding nurses in clinical decision-making, with significant sensitivity and specificity in identifying the risk of positioning-related injuries, including pressure ulcers, in adult patients during the intraoperative period. Its implementation is expected to be beneficial in healthcare settings, contributing to the prevention of complications associated with surgical positioning. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Design Setting Population Methods Main Outcome Measure Results Conclusions To present the rates of intra‐ and postoperative complications and conversions in a large cohort of unselected vNOTES hysterectomies, performed by surgeons with different levels of expertise.International register‐based cohort study.Hysterectomies in the iNOTESs registry, 2015 to January 2024, performed by 201 surgeons from multiple countries.4565 patients undergoing vNOTES hysterectomy.Descriptive data are presented in frequencies (n) and percent (%).Intra‐ and postoperative complications. Conversions.Intraoperative and postoperative complication rates were 3.2% (n = 144) and 2.5% (n = 115), respectively. Conversions occurred in 1.6% (n = 72), of which 10 (0.2%) to laparotomy, and 82% of the conversions occurred within the first 50 cases of the surgeon's learning curve. The most common intraoperative complication was cystotomy, occurring in 1.3%, and almost half were performed by inexperienced surgeons. Other intraoperative organ injuries occurred in 20 cases (0.44%). Postoperatively, the most common complications were haemorrhage (n = 28), vault complications (n = 26) including 11 infected vault hematomas, cystitis (n = 18) and non‐specific infections (n = 14). The vNOTES hysterectomies were performed by 201 surgeons, of which 9.5% had performed more than 50 vNOTES cases, representing 70% of the registered cases in the registry. The remaining 30% of the hysterectomies mainly represent learning curve data from 90% of the included surgeons. The complication rate decreased with increasing surgical experience.The largest study population of vNOTES hysterectomies is presented, including both learning curve data and data from experienced surgeons, with acceptable rates of intra‐ and postoperative complications. No implication was found of vNOTES being inferior to other minimally invasive methods. [ABSTRACT FROM AUTHOR]

Background: The malar bone provides an anchorage point for zygomatic implants, avoiding invasive reconstructive surgeries in the fixed rehabilitation of fully edentulous and severely atrophic maxillae. The limited bone volume, however, requires precise implant placement to prevent complications related to nearby anatomical structures. This observational cross-sectional study aims to measure the malar and zygomatic arch bones and their distances from critical anatomical landmarks to guide surgeons in safe zygomatic implant placement. Methods: Dissections were performed bilaterally on 29 heads from human donated bodies in a cross-sectional observational study. Key landmarks evaluated include the infraorbital foramen (IF), pyriform nasal aperture (PNA), infraorbital margin (IM), zygomaticofacial foramen (ZFF), anterior end (A), and the most protruding point of the zygomatic arch (B). Measurements included IF-PNA, IF-IM, IF-ZFF, ZFF-IM, A-B, and orbital floor depth (OFD). Results: Significant findings showed IF-PNA was greater in males (18.66 ± 2.63 mm, p = 0.001), and IF-ZFF varied between sides (26.72 ± 8.7 mm, p = 0.002). ZFF-IM was larger in males (7.43 ± 2.09 mm, p < 0.001). Heights and thicknesses were also assessed, with significant side differences observed. Conclusions: These findings underscore the importance of understanding precise anatomical distances for successful implant placement. The study provides essential data to enhance surgical planning and training, ensuring safer procedures and minimizing the risk of complications. [ABSTRACT FROM AUTHOR]

Objectives: Oroantral communication (OAC) is a relatively common and mild complication of maxillary tooth extractions. Preoperative prediction of OAC can reduce treatment duration and prepare both operators and patients for the procedure. This study aims to identify alarming radiographic and clinical indicators that can predict OAC therefore assisting clinical decision making to practicing general dentists. Methods: In this retrospective case–control study the OAC group consisting of 97 cases and a control group twice the size was established. Clinical data were collected, and measurements were conducted separately by two blinded observers on digital panoramic radiographs. Inter-rater reliability was assessed. In case of disagreement a third observer’s results were utilized. The correlation between OAC and demographic data (age, sex), as well as various factors assessed on panoramic radiographs (including, but not limited to, the length of the root, root projection into the sinus, bone width, presence of mesial and distal adjacent teeth), was statistically evaluated. Results: Inter-rater reliability was found to be excellent. Several factors were identified as potential predictors of OAC. According to our model, the strongest predictors were the distance between the cemento-enamel junction and marginal bone, extent of root projection into the sinus, presence of sinus recess around the roots, angulation, and absence of the mesial adjacent tooth. Conclusions: Well-defined measurements on panoramic radiographs may aid in predicting OAC. Further prospective investigations are necessary to confirm these indicators and address factors related to clinical examination and operation. Clinical relevance: We present several clinical and radiographic warning signs of OAC that can facilitate pre-extraction decision-making. [ABSTRACT FROM AUTHOR]

Background: Postoperative negative pressure pulmonary edema (NPPE) can occur in any patient undergoing general anesthesia. There are several risk factors for it, especially postoperative laryngospasm. The disease is usually benign and quickly reversible. In our case the severity and need for advanced critical care therapy was unusual. Case: We report a severe case of postoperative negative pressure pulmonary edema in a 62-year-old male patient undergoing elective right-sided retroperitoneoscopic adrenalectomy. The patient developed a severe case of acute respiratory distress syndrome (ARDS) after postoperative laryngospasm, possibly in conjunction with a suspected anaphylactic reaction. The patient was consequently treated with a combination of invasive airway pressure release ventilation (APRV) and a prone positioning regimen. After drastic improvement in respiratory function, the patient was discharged from the intensive care unit after 10 days and from the hospital after 14 days. Conclusion: NPPE is a rare but relevant complication of anesthesia and laryngospasm. The disease can basically occur in any patient undergoing general anesthesia and therefore should be considered. [ABSTRACT FROM AUTHOR]

Background: Due to advances in video-assisted thoracic surgery (VATS), the majority of lung resections can be performed safely via VATS with low morbidity and mortality. However, pulmonary artery (PA) bleeding often requires emergency conversion to thoracotomy, potentially leading to a life-threatening situation. We report a case of pulmonary artery injury caused by an unexpected stapler-tissue interaction during uniportal VATS lobectomy, highlighting the importance of recognizing and managing such rare complications to improve patient outcomes. Case presentation: A 63-year-old man underwent uniportal VATS left upper lobectomy for a suspected primary lung cancer. During the procedure, unexpected bleeding occurred from the third branch of the pulmonary artery (A3) after withdrawal of an unfired stapler. The protruding staple of the A3 stump was inadvertently hooked and stretched by the groove of the staple anvil. Although the bleeding was controlled by compression with the lung, the injured A3 stump required repair. Due to the extensive intimal injury near the central part of the left main pulmonary artery and the potential risk of fatal postoperative complications, we converted to open thoracotomy for definitive vascular repair by suturing. The patient had no postoperative complications and was discharged on postoperative day 8. Conclusions: This case report provides valuable lessons regarding the rare stapler-related vascular injury during uniportal VATS lobectomy. It is important to note that even during non-vascular dissection, unexpected stapler-tissue interactions can lead to bleeding. To prevent the vessel stump entanglement with stapler components, maintaining separation between the stapler and staple stumps is crucial. In uniportal VATS, manipulation during stapler insertion is one of the most challenging phases for instrument interference, requiring increased caution to prevent complications such as the vascular injury described in this case. Thorough preoperative planning, specific intraoperative precautions, and adapted safety protocols that address the limitations of uniportal VATS are essential for effective management of potential complications. Although techniques for thoracoscopic vascular control exist, they are not always feasible and conversion to open thoracotomy should be considered when necessary to ensure patient safety. [ABSTRACT FROM AUTHOR]

Purpose: The robot-assisted laparoscopic (RALUVR) and open (OUVR) approaches have both been described for ureterovesical reimplantation to treat benign lower ureteral pathologies. Thus, we aimed to compare the perioperative and functional outcomes of RALUVR vs. OUVR. Methods: We performed a retrospective comparative study including all consecutive patients treated with RALUVR or OUVR for benign lower ureteral pathologies between January 2013 and December 2022 at our center. Logistic regression analyses were used to assess the predictors of complication ≥ Clavien-Dindo (CD) III within 90 days, prolonged length of stay (LOS), and 90-day overall success. The Kaplan-Meier method and Cox regression analyses were used to assess vesicoureteral reflux-free (VU-RFS) and stenosis-free (SFS) survivals. Results: Overall, 44 patients underwent RALUVR (n = 19; 43%) and OUVR (n = 25; 57%). In univariable logistic regression analyses, the use of RALUVR vs. OUVR was not significantly associated with postoperative complications ≥ CDIII (OR = 0.98; 95% CI=[0.17–5.09]; p = 0.98), and 90-day overall success (OR = 1.43; 95% CI=[0.24–11.28]; p = 0.7). Despite a shorter median LOS after RALUVR vs. OUVR (4 vs. 10 days, respectively; p < 0.001), multivariable logistic regression analysis showed no impact of the surgical approach on prolonged LOS (OR = 0.51, 95% CI=[0.03–13.86]; p = 0.65). No significant difference was observed in 2-year VU-RFS (72.9% vs. 100%, respectively; p = 0.2) and 2-year SFS between the RALUVR and OUVR groups (85.7% vs. 87.7%, respectively; p = 0.8). In Cox regression analysis, the use of RALUVR vs. OUVR was not significantly associated with VU-RFS (HR = 4.26; 95% CI=[0.38–47.84]; p = 0.24) or SFS (HR = 1.32; 95% CI=[0.22–8.01]; p = 0.76). Conclusion: We observed that RALUVR provides similar perioperative and functional outcomes as compared to OUVR, except for potentially shorter LOS. [ABSTRACT FROM AUTHOR]

Maxillary sinus floor elevation is usually performed in two different ways: the lateral approach involves the creation of a bony window on the maxillary sinus lateral wall, providing direct access to the sinus cavity for membrane elevation and subsequent graft placement, and the transcrestal approach is considered less invasive. The aim of this article is to describe, based on the literature, how to anticipate, avoid, and manage the intraoperative complications that can occur with both approaches. For both approaches, the most common complication is the sinus membrane perforation. For the lateral approach, an average frequency ranging from 15.7% to 23.1% is reported, but because of the better visibility, their management will be easier compared to the transcrestal approach. Mean perforation rate reported for the transcrestal approach is lower (3.1%–6.4%), but it should be noted that a significant number of perforations cannot be detected and managed given the blind nature of this technique. Anatomical parameters such as sinus width and buccal wall thickness may be a risk factor for one approach and not the other. As it is impossible to assess the resistance of the Schneiderian membrane, the transcrestal approach is more likely to lead to infectious complications in the event of perforation. Others, such as the risk of vascular damage, are encountered only with the lateral approach, which can be prevented easily by dissecting the alveolo‐antral artery. For both approaches, prevention is essential and consists in analyzing the anatomy, mastering the surgical technique, and collaborating with the ENT to manage the essentially infectious consequences of intraoperative complications. [ABSTRACT FROM AUTHOR]

Purpose: To determine the outcomes and predisposing factors of Descemet's membrane endothelial keratoplasty (DMEK) complicated by intraoperative fibrinous reaction. Methods: Retrospective cohort study of 346 DMEKs. Medical charts were reviewed for recipient demographics, surgical indications, donor characteristics, and potential predisposing ocular and systemic factors. For DMEKs complicated by fibrin, surgeons' notes on events leading to fibrin formation and on its intraoperative management, occurrence of graft detachment, primary failure, re-bubbling or regrafting, time to graft clearing, and endothelial cell density were additionally collected. Results: Fifteen (4.3%) DMEKs were complicated by fibrin, which interfered with and protracted graft unfolding in all cases. Median surgical time was longer than for uncomplicated DMEKs (p = 0.001). Graft positioning at the end of surgery was suboptimal in seven eyes (47%) and failed in three (20%). Re-bubbling, primary failure, and regraft rates were of 40%, 33% and 53%, respectively. The corneas that cleared did so in three to eight weeks, with median endothelial cell loss of 53% at 12 months. Use of anticoagulants was a preoperative risk factor (p = 0.01). Surgeon-identified intraoperative factors included beginner surgeons (87%), prolonged AC shallowing (47%) and graft manipulations (33%), intraocular bleeding (27%), new injector (20%), tight donor scroll (13%), and floppy iris (13%). Conclusion: Fibrinous reaction is a rare intraoperative complication of DMEK that interferes with graft unfolding and results in poor outcomes. Anticoagulant use appears to be a risk factor and may be compounded by surgical trauma to vascular tissues and prolonged surgical maneuvers. [ABSTRACT FROM AUTHOR]

Background: Hysterectomy is one of the most common surgical procedures performed by the gynaecologist. It can be performed by vaginal, abdominal and laparoscopic route. Vaginal hysterectomy ranks as one of the least and minimally invasive types of hysterectomies, and it has better outcomes and fewer complications when compared to other types. This study assesses the intraoperative and postoperative complications of vaginal hysterectomy. Material & Methods: This hospital based retrospective observational study was carried out from March 2023 to March 2024. A total of 105 patients who underwent vaginal hysterectomy were included in this study. Age, parity, associated medical conditions like anaemia, diabetes, hypertension, thyroid disorders, indications for vaginal hysterectomy, intraoperative complications like excessive blood loss, bladder, bowel or ureteric injuries, conversion to TAH, postoperative complications like vault infection, subacute intestinal obstruction, VVF, RVF, stress urinary incontinence and vault prolapse were analysed. Results: Our study included 105 patients. Majority were in the age between 40 - 49 years (69%). AUB (L)was the commonest indication for vaginal hysterectomy (60%). There was no excessive blood loss for any patient and none needed blood transfusion. Bladder injury occurred in 1 case (0.9%), Subacute intestinal obstruction occurred in 1 case (0.9%), conversion to TAH in 2 cases (1.8%). 2 cases (1.8%) developed vault cellulitis, whereas 3 cases (2.7%) developed stress urinary incontinence. Conclusions: In majority of the cases, no intraoperative complications were found suggesting low morbidity associated with the procedure. The postoperative hospital stay was restricted to 4 days in 85.7% of cases which indicates early discharge of the patient. Post-operative complications such as vault cellulitis(1.8%) and stress urinary incontinence(2.7%) were seen only in few cases. So, Vaginal hysterectomy is associated with quicker recovery, early mobilization, shorter hospitalization, less operative and postoperative morbidity. Therefore, vaginal hysterectomy should be considered as the primary route for all hysterectomies unless contraindicated. [ABSTRACT FROM AUTHOR]

Objective To determine the prevalence, prevention measures, and risk factors for occult periprosthetic fractures after primary total hip arthroplasty (THA), as well as to determine whether or not they are the root of early THA failure. Methods From January 2014 to December 2018, 755 patients (769 hips) underwent primary total hip arthroplasty were retrospectively analyzed, including 327 males (339 hips) and 428 females (430 hips). X-ray, CT and 3D reconstruction of hip were performed before and after operation. By using CT to diagnose the occult fractures, the patients were then monitored and evaluated. Age, sex, body mass index (BMI), preoperative diagnosis, osteoporosis, kind of prosthesis, and the surgeon's experience should all be considered. Patients with occult fracture were followed up, the fracture healing and prosthesis stability were recorded and analyzed. Results There are 23 of 769 cases (23/769) had occult fracture around the prosthesis, with an incidence of 2.99% (23/769);. The total revision rate was 0.52% (4/769). The revision patients accounted for 17.39% (4/23) of the patients with occult femoral fractures. The remaining patients received conservative care and successfully joined without their prostheses slipping. Osteoporosis, body mass index, and the surgeon's experience were identified as the risk variables for periprosthetic occult fractures by univariate analysis (P < 0.05). Conclusion Periprosthetic occult fracture was a complication that can not be ignored in primary total hip arthroplasty. It is the cause of early failure of prosthesis. Osteoporosis, BMI and the surgeon's experience are all risk factors for periprosthetic occult fractures. [ABSTRACT FROM AUTHOR]

Introduction: Preoperative fasting is a standard practice aimed at minimising the risk of pulmonary aspiration during surgery. However, patients often experience prolonged fasting periods beyond the recommended duration due to unanticipated delays in the operating theatre, communication failures between teams, inadequate preoperative planning and other factors. Aim: To investigate the effects of unexpectedly prolonged fasting on intraoperative and postoperative parameters in patients undergoing elective surgery under spinal anaesthesia. Materials and Methods: This prospective observational study was conducted from October 2023 to June 2024 at the Department of Anaesthesiology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India. The study included 70 patients undergoing elective surgery under spinal anaesthesia. Patients were divided into two groups: Group A (AM group, n=35), scheduled for surgery between 8:00 AM and 12:00 PM and Group B (PM group, n=35), scheduled for surgery after 12:00 PM or with delayed surgeries. Intraoperative parameters, including Mean Arterial Pressure (MAP), Heart Rate (HR), oxygen saturation (SpO2) and random blood glucose levels, were recorded at specific time points. Postoperative outcomes, such as nausea, vomiting and random blood glucose levels, were also assessed. Continuous and discrete variables were summarised as mean±SD and median, while categorical variables were presented as frequencies and percentages. Associations between categorical variables were tested using Pearson's Chi-square or Fisher's-exact test, with p-values<0.05 considered statistically significant. Results: The PM group exhibited higher preoperative random blood glucose levels (102.3±18.7 mg/dL) compared to the AM group (89.2±12.5 mg/dL). Postoperative nausea and vomiting were observed in 5 (14.3%) patients in the AM group and 11 (31.4%) patients in the PM group. Both groups showed a gradual decrease in MAP and HR from the preoperative period to 30 minutes after spinal anaesthesia administration, with slightly higher values noted in the PM group. No significant differences in SpO2 were observed between the groups. Conclusion: Unexpected prolonged fasting before elective surgery under spinal anaesthesia may contribute to higher preoperative blood glucose levels and an increased risk of postoperative nausea and vomiting. These findings underscore the importance of adhering to preoperative fasting guidelines and exploring potential strategies to minimise prolonged fasting periods, such as carbohydrate loading or allowing clear fluids closer to surgery. [ABSTRACT FROM AUTHOR]

Background and Aims: Although Spinal Anesthesia (SA) remains the technique of choice for many surgeries below the umbilicus, it is associated with multiple intraoperative complications. Sympathetic blockade and Bezold‐Jarisch reflex do not fully explain SA‐related cardiopulmonary complications. Reduction in FEV1 has been reported as a predictor of sudden cardiac death. This study aimed to determine the association between reduction in FEV1 following SA and adverse intraoperative cardiopulmonary complications. Materials and Methods: A prospective study of 48 patients of ASA status I and II with no history of primary cardiopulmonary disease scheduled for elective surgery under SA. Spirometry was performed based on ATS/ERS guidelines before induction and 30 min after induction of SA. FEV1% predicted was determined using GLI 2012 equations. Participants were grouped into two (∆FEV1% < 10% and ∆FEV1% ≥ 10%) based on reductions (∆) in FEV1% predicted following SA. Logistic regression analyses were used to examine associations between ∆FEV1% and intraoperative hypoxia, hypotension, bradycardia, and nausea/vomiting, with adjustments for age, gender, and BMI. Results: The mean FEV1% predicted following SA was lower than the mean FEV1% predicted before SA (83.42 vs. 95.31, p = 0.001). In a fully adjusted model, ∆FEV1% ≥ 10% was associated with an increased risk of hypoxia [AOR 13.55; 95% CI, 1.07–171.24, p = 0.044]. The positive associations between ∆FEV1% ≥ 10% and hypotension [2.02 (0.33–12.46), 0.449], bradycardia [1.10 (0.28–4.25), 0.895] and nausea/vomiting [9.74 (0.52–183.94), 0.129] were not statistically significant. Conclusion: Reduction in FEV1% predicted following SA was associated with adverse intraoperative outcomes. FEV1 may play an important role in the association between SA and cardiopulmonary complications. [ABSTRACT FROM AUTHOR]

Abstract Objectives To evaluate the feasibility and safety of robotic‐assisted salvage radical cystectomy (RA‐SRC). Materials and Methods We retrospectively searched the prospectively collected surgical database of two highly experienced robotic urological surgeons for cases of RA‐SRC, defined as RARC performed post‐previous pelvic RT for palliative or oncologic treatment purposes. Collected data included demographic and clinical information and outcome measures including operative course, hospital stay and complications. Results Eighteen patients were included in the current analysis. All patients had previous RT to the pelvis with 12 patients also having prior radical pelvic surgery. Indications for salvage cystectomy were either palliation (n = 12) or oncological (MIBC or high risk NMIBC, n = 6). There were no intraoperative complications and no conversions to open surgery. Ninety day postoperative complications were recorded in 11 patients (61.1%), with major complications (Clavien–Dindo grades 3 and 4) in three patients (16.6%). After a median follow‐up of 43.5 months, one late postoperative complication was observed requiring surgical intervention. Conclusion Our data, together with the limited published data from other cohorts of RA‐SRC, suggest that in experienced hands, RA‐SRC is feasible, with intraoperative and perioperative complication rates that are lower than the published data for open SRC and are equivalent to open primary RC. These data will contribute to treatment decision making both in patients with post‐pelvic radiation symptoms requiring palliation and patients with MIBC considering or treated with trimodal treatment.

Abstract Background The detachment of a resectoscope sheath tip during transurethral prostate resection can lead to the troubling issue of an iatrogenic-retained foreign body if not promptly identified. Various endoscopic techniques designed to prevent the necessity for open surgery are well documented in the literature. However, most of these strategies involve considerable cost or require equipment that may not always be readily available. Here, we describe a novel and simple technique for removal that does not require expensive materials. Case presentation The tip of a standard Storz 26 Fr continuous flow resectoscope inner sheath was successfully retrieved using a 2–0 polypropylene thread and a rigid cystoscope during a prostate resection procedure to treat benign hyperplasia of the gland. Addressing surgical complications, especially the removal of foreign bodies from the bladder, is often challenging, particularly when technical resources are limited. Various approaches for removing a detached resectoscope tip have been described, indicating that none offer a perfect solution. To our knowledge, this is the first report detailing the effective use of a simple surgical suture and endoscopic forceps in conjunction with a rigid cystoscope for removing a foreign body from the bladder. Conclusions The technique described here may be considered a safe, cost-effective, and relatively straightforward procedure that could be beneficial to urological surgeons, particularly when working under suboptimal conditions.

Abstract Background Hysteroscopic surgery is a safe procedure used for diagnosing and treating intrauterine lesions, with a low rate of intraoperative complications. However, it is important to be cautious as fluid overload can still occur when performing any hysteroscopic surgical technique. Case Presentation In this case report, we present a unique instance where lung ultrasound was utilized to diagnose pulmonary edema in a patient following a hysteroscopic myomectomy procedure. The development of pulmonary edema was attributed to the excessive absorption of fluid during the surgical intervention. By employing lung ultrasound as a diagnostic tool, we were able to promptly identify and address the pulmonary edema. As a result, the patient received timely treatment with no complications. This case highlights the importance of utilizing advanced imaging techniques, such as lung ultrasound, in the perioperative management of patients undergoing hysteroscopic procedures. Conclusions This case report underscores the significance of early detection and intervention in preventing complications associated with fluid overload during hysteroscopic myomectomy procedures.