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Surgical Techniques Development
Volume 14
Issue 3
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Surg. Tech. Dev., Volume 14, Issue 3 (September 2025) – 5 articles

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14 pages, 1932 KiB  
Article
The Treatment of Three-Part Fractures of Humeral Head: A Retrospective Study to Compare Nail vs. Plate
by Francesco Roberto Evola, Michele Vecchio, Marco Vacante and Giuseppe Evola
Surg. Tech. Dev. 2025, 14(3), 23; https://doi.org/10.3390/std14030023 - 12 Jul 2025
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Abstract
Background: There are no clear guidelines to support management decisions for patients with three-part fractures of the proximal humerus. The aim of the study is to identify the treatment used and to assess the functional and radiological outcomes at follow-up. Methods: A total [...] Read more.
Background: There are no clear guidelines to support management decisions for patients with three-part fractures of the proximal humerus. The aim of the study is to identify the treatment used and to assess the functional and radiological outcomes at follow-up. Methods: A total of 126 patients were retrospectively included in the study and were divided into two groups based on the type of surgery: plate and nail group. We collected data on the patient’s sex, age, fracture type, surgery duration, fracture healing, initial and final neck–shaft angles, shoulder joint score, and complications. Results: A total of 69 patients received locking-plate internal fixation, while 77 patients underwent fixation with intramedullary nail. The two groups were comparable, with no significant differences observed in age, sex, or the number of patients. The average operation time for the locking-plate group (88.7 ± 10.5 min) was significantly longer compared to the intramedullary nail group (70.2 ± 8.3 min). The Constant–Murley score was 91.2 ± 6.7 (range 79–98) in the plate group and 90.5 ± 7.7 (range 80–98) in the nail group, with no statistically significant difference. Complications were observed in 16 patients (23.2%) of the locking-plate group and in 7 patients (9.1%) of the intramedullary nail group, with significant difference. Conclusions: Our assessment revealed no significant differences in fracture healing times, loss of reduction, or Constant–Murley scores between two groups. However, our results suggest that intramedullary nails have an advantage over locking plates in terms of reduced operation time and complications. Full article
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12 pages, 1773 KiB  
Review
Advances in 3D-Printed Implants for Facial Plastic Surgery
by Joan Birbe Foraster
Surg. Tech. Dev. 2025, 14(3), 22; https://doi.org/10.3390/std14030022 - 1 Jul 2025
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Abstract
Facial reconstruction presents complex challenges due to the intricate nature of craniofacial anatomy and the necessity for individualized treatment. Conventional reconstructive methods—such as autologous bone grafts and prefabricated alloplastic implants—pose limitations, including donor site morbidity, implant rejection, and suboptimal aesthetic results. The emergence [...] Read more.
Facial reconstruction presents complex challenges due to the intricate nature of craniofacial anatomy and the necessity for individualized treatment. Conventional reconstructive methods—such as autologous bone grafts and prefabricated alloplastic implants—pose limitations, including donor site morbidity, implant rejection, and suboptimal aesthetic results. The emergence of 3D printing technology has introduced patient-specific implants (PSIs) that enhance anatomical fit, functional restoration, and biocompatibility. This review outlines the evolution of 3D-printed implants, key materials, computer-assisted design (CAD), and their applications across trauma, oncology, congenital conditions, and aesthetics. It also addresses current challenges and explores future directions, such as bioprinting, smart implants, and drug-eluting coatings. Full article
(This article belongs to the Special Issue New Insights into Plastic Aesthetic and Regenerative Surgery)
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19 pages, 286 KiB  
Review
Surgeon Training in the Era of Computer-Enhanced Simulation Robotics and Emerging Technologies: A Narrative Review
by Simon Keelan, Mina Guirgis, Benji Julien, Peter J. Hewett and Michael Talbot
Surg. Tech. Dev. 2025, 14(3), 21; https://doi.org/10.3390/std14030021 - 27 Jun 2025
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Abstract
Background: Teaching methodology has recently undergone significant evolution from traditional apprenticeship models as we adapt to ever-increasing rates of technological advancement. Big data, artificial intelligence, and machine learning are on the precipice of revolutionising all aspects of surgical practice, with far-reaching implications. [...] Read more.
Background: Teaching methodology has recently undergone significant evolution from traditional apprenticeship models as we adapt to ever-increasing rates of technological advancement. Big data, artificial intelligence, and machine learning are on the precipice of revolutionising all aspects of surgical practice, with far-reaching implications. Robotic platforms will increase in autonomy as machine learning rapidly becomes more sophisticated, and therefore training requirements will no longer slow innovation. Materials and Methods: A search of published studies discussing surgeon training and computer-enhanced simulation robotics and emerging technologies using MEDLINE, PubMed, EMBASE, Scopus, CRANE, CINAHL, and Web of Science was performed in January 2024. Online resources associated with proprietary technologies related to the subject matter were also utilised. Results: Following a review of 3209 articles, 91 of which were published, relevant articles on aspects of robotics-based computer-enhanced simulation, technologies, and education were included. Publications ranged from RCTs, cohort studies, meta-analysis, and systematic reviews. The content of eight medical technology-based websites was analysed and included in this review to ensure the most up-to-date information was analysed. Discussion: Surgeons should aim to be at the forefront of this revolution for the ultimate benefit of patients. Surgical exposure will no longer be due to incidental experiences. Rather, surgeons and trainees will have access to a complete database of simulated minimally invasive procedures, and procedural simulation certification will likely become a requisite from graduation to live operating to maintain rigorous patient safety standards. This review provides a comprehensive outline of the current and future status of surgical training in the robotic and digital era. Full article
11 pages, 2077 KiB  
Technical Note
Laparoscopic-Assisted Percutaneous Cryoablation of Abdominal Wall Desmoid Fibromatosis: Case Series and Local Experience
by Kadhim Taqi, Jaymie Walker, Cecily Stockley, Antoine Bouchard-Fortier, Stefan Przybojewski and Lloyd Mack
Surg. Tech. Dev. 2025, 14(3), 20; https://doi.org/10.3390/std14030020 - 24 Jun 2025
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Abstract
Background: Desmoid tumors (DTs) are rare, non-metastatic but locally aggressive connective tissue neoplasms. While standard treatments include surgery, radiation, and ablation, current guidelines advocate active surveillance unless tumors progress or symptoms worsen. Cryotherapy has shown promise in treating DTs; however, its application in [...] Read more.
Background: Desmoid tumors (DTs) are rare, non-metastatic but locally aggressive connective tissue neoplasms. While standard treatments include surgery, radiation, and ablation, current guidelines advocate active surveillance unless tumors progress or symptoms worsen. Cryotherapy has shown promise in treating DTs; however, its application in rectus abdominis DTs has been limited due to proximity to critical intra-abdominal structures. Methods: This case series describes a novel approach involving laparoscopic-assisted cryoablation in three patients with rectus abdominis DTs. Laparoscopic visualization was employed to improve tumor localization and procedural safety during percutaneous cryoablation. Results: The average tumor size was 7.4 cm, and a mean of 14 cryoprobes were used per case. All patients experienced complete symptom resolution. One patient developed a complication—injury to the inferior epigastric artery—requiring embolization. Follow-up imaging at three months showed significant tumor shrinkage and necrosis in two patients. The third patient had increased lesion volume due to post-procedural hematoma, although radiological markers of cryoablation efficacy were present. Conclusions: Laparoscopic-assisted cryoablation appears to be a feasible and effective technique for treating rectus abdominis DTs, providing symptom relief and favorable early tumor response. Further studies are warranted to evaluate long-term outcomes and validate this approach in broader clinical settings. Full article
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7 pages, 4665 KiB  
Case Report
Endless-Loop Craniotomy for Revision Surgery After the Burr-Hole Evacuation of Chronic Subdural Hematoma—A Technical Note
by Artem Rafaelian, Sae-Yeon Won, Thomas M. Freiman, Florian Gessler and Daniel Dubinski
Surg. Tech. Dev. 2025, 14(3), 19; https://doi.org/10.3390/std14030019 - 21 Jun 2025
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Abstract
Background and Importance: Chronic subdural hematoma (cSDH) is a common and complex neurosurgical problem, particularly in elderly patients. Revision surgery for chronic subdural hematoma can be challenging, particularly in cases with inhomogeneous, firm consistency and extensive adhesions. Clinical Presentation: In this article, we [...] Read more.
Background and Importance: Chronic subdural hematoma (cSDH) is a common and complex neurosurgical problem, particularly in elderly patients. Revision surgery for chronic subdural hematoma can be challenging, particularly in cases with inhomogeneous, firm consistency and extensive adhesions. Clinical Presentation: In this article, we present our endless-loop craniotomy technique, which offers a novel approach to address these challenges by performing the wide, curved exposure of the subdural space utilizing the already-present burr hole. This technique allows for a wide, unobstructed view of the subdural space, enabling the access and evacuation of this chronic and often adhesive subdural hematoma. Conclusion: We believe that endless-loop craniotomy is a valuable addition to the neurosurgeon’s armamentarium for managing complex cases of revision surgery in chronic subdural hematomas. Full article
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