Search Results (226)

The documentation and reconstruction of fragile underwater organic artifacts remain among the most challenging tasks in digital heritage practice. This study presents a conservation-first, contact-minimizing protocol applied to a rare Byzantine leather bag recovered from the commercial port of Rhodes, Greece. Due to its incomplete preservation and structural instability, exclusively non-invasive methodologies were employed. High-resolution close-range photogrammetry and structured-light 3D scanning were integrated to capture both micro-topographic detail and metrically stable geometry. Quantitative deviation analysis (nearest-neighbor cloud-to-mesh distances) indicated that most geometric differences remain below 0.5 mm. The resulting models were processed through controlled mesh optimization, UV remapping, and conservation-oriented digital completion workflows. In addition, radiance field visualization techniques such as Gaussian Splatting were explored as complementary visualization approaches for incomplete geometries. These methods were evaluated primarily in terms of visual continuity and interpretative support rather than as reconstruction tools. The study demonstrates that the integration of photogrammetry, structured-light scanning, and Gaussian Splatting can significantly enhance the documentation and visualization of fragile underwater organic heritage. At the same time, it highlights the necessity of methodological transparency and ethical framing when incorporating probabilistic reconstructions into conservation workflows. Full article

Background/Objectives: Robot-assisted partial nephrectomy (RAPN) has increasingly replaced laparoscopic partial nephrectomy (LPN) in the management of localized renal tumours. This study aimed to evaluate perioperative, functional and surgical margin outcomes during an institutional transition from LPN to RAPN in a high-volume centre. Methods: We performed a retrospective single-centre analysis of 100 consecutive patients undergoing minimally invasive partial nephrectomy. The last 50 LPN cases (August 2014–May 2018) were compared with the first 50 RAPN cases (June 2018–February 2020). Baseline characteristics, perioperative outcomes, early functional parameters and surgical margin status were analysed. Complications were classified according to the Clavien–Dindo system. Results: Tumours treated in the RAPN group were significantly larger (3.4 vs. 2.5 cm) and more complex (RENAL score of 6 vs. 5; p < 0.001). Operative time was longer in the RAPN group (143 vs. 122 min; p < 0.01), while warm ischaemia time did not differ significantly (16 vs. 15 min; p = 0.37). Estimated blood loss was lower (0 vs. 10 mL; p = 0.049) and the hospital stay was shorter (3 vs. 4 days; p < 0.001) in the RAPN group. Haemoglobin decrease and postoperative creatinine change were comparable between groups. Positive surgical margins were observed less frequently in the RAPN group (2.3% vs. 7.7%), but this difference was not statistically significant (p = 0.34). Complication rates were significantly lower in the RAPN group (4% vs. 22%; p < 0.05), with no major complications observed in the robotic cohort. Conclusions: In this institutional experience, RAPN was associated with favourable perioperative outcomes during the transition period, despite the treatment of larger and more complex renal tumours. The slightly longer operative and warm ischaemia times likely reflect a more comprehensive reconstruction strategy, which may contribute to improved haemostatic control and lower complication rates. Further studies with extended follow-up are required to evaluate oncological and renal functional outcomes. Full article

Background: The evolution of digital dentistry has enabled the development of more predictable and less invasive protocols for bone augmentation and prosthetic rehabilitation. This case report introduces an integrated digital workflow combining the Digital CarroTrack technique with the “One-Step Crown” concept to optimize clinical outcomes and efficiency. Case Description: A patient requiring alveolar ridge reconstruction and implant therapy was treated using the Digital CarroTrack technique. This approach utilized precise digital planning to simultaneously harvest an autogenous bone cylinder from the surgical site and reposition it for augmentation, eliminating the need for a secondary donor site. Following implant placement, a “one-step crown” protocol was implemented. A provisional restoration served as a template for soft tissue contouring, and its emergence profile was directly replicated in a pre-designed definitive crown. The bone cylinder fixation screw was retrieved during the final prosthetic delivery, ensuring a streamlined workflow. Results: In this case, the integrated digital approach facilitated accurate bone cylinder placement and implant positioning. At the 2-year follow-up, clinical and radiographic examinations confirmed excellent stability of both hard and soft tissues, with no marginal bone loss or soft tissue recession. The procedure reduced the number of clinical stages, treatment time, and patient morbidity compared to traditional methods. Conclusions: This case report suggests that the combination of the Digital CarroTrack Technique and the One-Step Crown concept may represent a promising, minimally invasive, and time-efficient approach for complex implant-prosthetic cases. Digital planning appeared to support procedural accuracy while reducing surgical invasiveness and the number of clinical stages. Further prospective studies with larger patient groups, objective volumetric measurements, longer follow-up, and dedicated cost-effectiveness analyses are needed to confirm the predictability, clinical effectiveness, and potential economic benefits of this approach. Full article

Minimally invasive pancreas-preserving duodenal resection (MIPPDR) encompasses laparoscopic, robotic, and intentionally hybrid duodenal resections performed without pancreatic parenchymal excision, ranging from transduodenal local excision or ampullectomy to sleeve, segmental, subtotal, near-total, and total duodenectomy. This targeted narrative review was designed to provide a clinically oriented synthesis of the available literature on indications, operative strategies, platform selection, reconstruction, perioperative outcomes, oncological adequacy, and functional considerations. A structured literature search was performed in PubMed/MEDLINE, Scopus, and Web of Science up to March 2026. The review focused on minimally invasive or intentionally hybrid pancreas-preserving duodenal resections reporting operative technique, perioperative outcomes, oncological outcomes, or functional sequelae. The minimally invasive literature consisted predominantly of case reports, technical notes, video articles, and small retrospective series, with substantial heterogeneity in lesion type, anatomical location, procedure extent, reconstruction, and outcome reporting. Laparoscopy appeared most reproducible for distal, infra-papillary, and limited resections with relatively low reconstructive burden, whereas robotics appeared to offer specific technical advantages for periampullary dissection, ductal identification, and intracorporeal reconstruction. However, the available evidence was insufficient to define firm comparative indications between platforms or to demonstrate superiority of one minimally invasive approach over another. Functional outcomes, despite their central relevance to the rationale of pancreas preservation, were poorly standardized and inconsistently reported. MIPPDR was therefore interpreted as a selective pancreas-preserving strategy positioned between advanced endoscopic therapy and pancreaticoduodenectomy. Future studies should adopt anatomy-based reporting, distinguish ampullary, periampullary, and distal duodenal disease, and include standardized functional endpoints. Full article

Intrabody cage augmentation has emerged as a minimally invasive technique for anterior column reconstruction in Kümmell disease and osteoporotic burst fractures. These osteoporotic conditions lead to progressive vertebral collapse, kyphosis, and instability. While cement augmentation provides rapid pain relief, it often fails to reliably restore sagittal balance or ensure biological integration in advanced stages of collapse. Although conventional anterior corpectomy with long-segment posterior fusion can achieve satisfactory deformity correction, these procedures are associated with substantial surgical morbidity. In contrast, screw fixation alone often fails to withstand anterior loading, resulting in loss of correction or hardware failure. By adapting standard interbody devices for off-label intravertebral use, this technique utilizes the intravertebral cleft as a natural cavity to restore vertebral height and sagittal alignment while preserving adjacent intervertebral discs and reducing stress on posterior instrumentation. The surgical technique involves transpedicular access, meticulous curettage of necrotic tissue, and insertion of a cage packed with osteoinductive material. This approach minimizes surgical trauma and operative time compared with conventional corpectomy procedures. Reported outcomes from retrospective series suggest promising pain relief, maintenance of correction, and low complication rates. Collectively, current evidence suggests that intrabody cage augmentation may serve as a potential, less invasive surgical option, acting as an intermediate approach between cement augmentation and corpectomy. However, as the existing evidence remains preliminary, high-quality prospective comparative studies are required to establish definitive indications and long-term efficacy. Full article

Background: Radical cystectomy (RC) remains associated with substantial perioperative morbidity despite advances in minimally invasive surgery and reconstructive techniques. Comparisons between intracorporeal reconstruction, robotic-assisted approaches, and urinary diversion strategies are frequently confounded by clinical heterogeneity and patient selection. This study aimed to perform a stratified surgical systematic review evaluating perioperative outcomes across distinct reconstructive pathways following RC. Methods: A PRISMA-guided systematic review identified comparative studies evaluating intracorporeal versus extracorporeal/open orthotopic neobladder reconstruction, robotic-assisted versus open radical cystectomy in frail patients undergoing ureterocutaneostomy, and ileal conduit versus orthotopic urinary diversion. Analyses were performed within predefined clinical modules to preserve surgical context. Outcomes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs), complemented by rare-event sensitivity analyses and exploratory absolute risk metrics, including number needed to treat or harm (NNT/NNH). Continuous outcomes such as estimated blood loss and length of hospital stay were assessed descriptively. Results: Three comparative observational cohorts met inclusion criteria. Intracorporeal neobladder reconstruction and robotic-assisted cystectomy demonstrated consistent reductions in transfusion rates and favourable trends in perioperative morbidity. In frail patient populations, robotic surgery showed reduced intraoperative burden without increased readmission or mortality. Ileal conduit diversion was associated with increased wound-related complications and infectious outcomes; however, these findings likely reflect baseline differences in patient frailty and selection. Rare-event sensitivity analyses confirmed directional consistency of treatment effects despite wide confidence intervals. Integration of absolute risk differences and NNT/NNH metrics provided clinically interpretable context for stratified outcomes. Conclusions: Minimally invasive and intracorporeal strategies following radical cystectomy may reduce perioperative burden, whereas diversion type primarily influences complication patterns rather than overall morbidity. A stratified analytical framework integrating relative and absolute effect measures may offer a more clinically meaningful approach to evaluating reconstructive strategies in heterogeneous surgical populations. Full article

Today, the rapid progress in non-invasive light–matter interaction analysis is transforming the landscape of biomedical and life sciences driven by low-intensity light detection technologies. As the complexity of photonic applications continues to grow, the importance of single-photon detection techniques becomes pivotal. Among them, Time-Correlated Single-Photon Counting (TCSPC) has become the gold standard for precise, time-resolved reconstruction of rapid and faint optical signals. However, TCSPC has long been constrained by pile-up distortion, which worsens with increasing acquisition speed, typically limiting it to 5% of the excitation frequency. To overcome the operational constraints of conventional implementations, a novel TCSPC acquisition methodology has been introduced, independent of photodetector dead time, excitation intensity, and prior optical signal knowledge, still enabling distortion-free reconstruction of the measured light profiles. In this context, the development of single-photon detectors with short dead time and low timing jitter becomes crucial. This work presents a single-photon detection module based on a Silicon Photomultiplier, which delivers 750 ps FWHM output pulses with a 33.5 ps RMS IRF. Its performance is showcased through fluorescence measurements employing the constraint-free TCSPC methodology, achieving a photon count rate up to 166% of the excitation frequency with a minimal lifetime estimation error of just −1.46%. Full article

Background and Objectives: Bladder neck stenosis (BNS) and vesicourethral anastomotic stenosis (VUAS) are challenging complications following prostate surgery and radiation therapy, with recurrence rates reaching 30–60% after conventional endoscopic management. The Optilume^® paclitaxel drug-coated balloon (DCB) has emerged as a novel minimally invasive treatment combining mechanical dilation with local anti-fibrotic drug delivery. This narrative review synthesizes current evidence on Optilume DCB specifically for BNS and VUAS. Materials and Methods: A comprehensive literature search identified eight relevant publications (2024–2026), including randomized controlled trials, prospective and retrospective cohort studies, and case series addressing Optilume DCB for posterior urethral stenoses. Results: Across the reviewed studies, freedom from reintervention for BNS ranged from 77.5% to 100% at 12 months, while VUAS outcomes were more variable (40–81%). A comparative study of 141 patients demonstrated significantly improved recurrence-free survival with DCB versus standard endoscopic treatment (HR 0.40, p = 0.021). Radiation-induced posterior urethral stenosis showed 81.1% freedom from repeat intervention. Complications were predominantly minor (Clavien-Dindo grade I), with no de novo incontinence attributable to the device. Conclusions: Optilume DCB represents a promising minimally invasive option for BNS and VUAS, particularly in patients with recurrent disease or those unsuitable for reconstructive surgery. BNS appears to respond more favorably than VUAS, likely reflecting distinct pathophysiological mechanisms. Prior radiation therapy remains a negative prognostic factor. Prospective randomized trials with longer follow-up are needed to define the role of DCB in posterior urethral stenosis management. Full article

Background and Objectives: Intramedullary headless screw (IMHS) fixation is a minimally invasive and biomechanically stable option for metacarpal fractures. However, the suitability of commonly used screw diameters may be limited by the morphometric features of the intramedullary canal. This study evaluated the isthmus morphology of the second to fifth metacarpals using computed tomography (CT)-based morphometric analysis and virtual screw simulation. Materials and Methods: A retrospective morphometric study was conducted using 75 hand CT scans, representing 300 metacarpals (second to fifth). Three-dimensional reconstructions were created with Mimics software (Materialise, Leuven, Belgium), and the isthmus level was identified by serial axial CT analysis. Canal diameters were measured at this level, and bone-specific virtual screw models were generated in Rhinoceros 3D and imported into Mimics for virtual implantation and canal conformity assessment. Feasibility rates were calculated for screw diameters between 2.75 mm and 4.00 mm. The effects of age and gender were also analyzed. Results: The fourth metacarpal had the smallest mean isthmus diameter (2.64 ± 0.89 mm), while the fifth had the largest (3.21 ± 0.84 mm). Feasibility decreased as screw diameter increased across all metacarpals. The fourth metacarpal showed the lowest compatibility, with feasibility rates of 10.7% for 3.5 mm screws and 4.0% for 4.0 mm screws. In contrast, the fifth metacarpal had the highest feasibility at smaller diameters, with 74.7% compatibility for 2.75 mm screws and 62.7% for 3.0 mm screws. Positive correlations were found between age and isthmus diameters of the second and third metacarpals, indicating age-related canal widening. Conclusions: The anatomical feasibility of IMHS fixation in the second to fifth metacarpals is influenced by isthmus morphology. The fourth metacarpal appears to be the most restrictive, particularly for screws ≥ 3.5 mm. These findings support individualized CT-based preoperative templating rather than standardized implant selection to improve screw canal compatibility and reduce cortical compromise risk. Full article

Background and Objectives: Intraoperative assessment of tissue perfusion remains a decisive but imperfect step in abdominal surgery. Surgeons still rely heavily on visual judgement when choosing bowel transection lines, constructing anastomoses, judging intestinal viability, or assessing graft reperfusion, even though these decisions are directly linked to anastomotic leak, conduit ischemia, postoperative liver dysfunction, and graft failure. Hyperspectral imaging (HSI) is an emerging contrast-free optical technology that generates quantitative maps of tissue oxygenation, hemoglobin distribution, water content, and near-infrared perfusion. The present review was designed to evaluate whether clinical intraoperative HSI has matured sufficiently to support a focused systematic review topic in abdominal surgery and to synthesize the currently available human evidence. Methods: A literature search was conducted up to 20 February 2026 using combinations of the terms “hyperspectral imaging”, “HSI”, “abdominal surgery”, “colorectal”, “hepatectomy”, “transplantation”, “pancreatoduodenectomy”, “esophagectomy”, “mesenteric ischemia”, and “intraoperative”. Eligible records were original human clinical studies evaluating intraoperative HSI in abdominal or transplant-related operations with perfusion, oxygenation, or tissue viability as a central endpoint. Review articles, animal studies, non-surgical diagnostic studies, and single-patient case reports were excluded. Data were synthesized narratively because of major heterogeneity in indications, designs, devices, timing of measurements, and reported outcomes. Results: Thirteen studies published between 2019 and 2024 met the eligibility criteria, representing 391 patients. The literature covered colorectal resection, acute mesenteric ischemia, esophageal reconstruction with gastric or colonic conduits, pancreatoduodenectomy, pancreas transplantation, major hepatectomy, liver transplantation, and minimally invasive system validation. Across colorectal studies, HSI frequently demonstrated discordance between visually selected and objectively perfused transection lines, with clinically relevant strategy changes in a substantial proportion of patients. In ischemic and transplant settings, HSI discriminated poorly perfused tissue, identified low near-infrared perfusion values associated with early allograft dysfunction, and quantified reperfusion patterns after clamping or implantation. The evidence base was dominated by prospective single-center feasibility studies with small to moderate sample sizes, and no randomized trials were identified. Conclusions: Clinical intraoperative HSI in abdominal surgery is a genuinely niche yet rapidly expanding topic with a sufficient number of human studies to support a relevant systematic review. Current evidence consistently supports feasibility, quantitative perfusion discrimination, and plausible intraoperative utility, especially in colorectal and transplant-related surgery. However, the field remains methodologically heterogeneous, and the next research priority is multicenter standardization with clinically anchored thresholds and outcome-driven comparative studies. Full article

Background and Clinical Significance: The management of large benign ovarian cysts in women of reproductive age requires balancing minimally invasive surgery with oncologic safety and preservation of ovarian function. Laparoscopic cystectomy for large cysts is technically challenging and carries an increased risk of intraoperative rupture and spillage; Case Presentation: We describe a novel hybrid laparoscopic–extracorporeal technique in which controlled cyst decompression is performed using a balloon-tipped trocar through a suprapubic port under direct laparoscopic visualization. The ovary is then carefully mobilized and exteriorized through the same incision, allowing extracorporeal cystectomy and ovarian reconstruction before returning the adnexa to the abdominal cavity. This approach was applied in a series of six patients with large benign-appearing ovarian cysts, including one 42-year-old patient with an 18 cm multilocular mature cystic teratoma. There were no intraoperative or postoperative complications, no conversions to laparotomy, and all patients were discharged on postoperative day 1. Follow-up at six weeks and subsequent imaging at nine months demonstrated preserved ovarian architecture, normal menstrual function, and high patient satisfaction; Conclusions: The hybrid laparoscopic–extracorporeal approach appears feasible and may offer a safe surgical option in carefully selected patients, allowing fertility preservation while minimizing the risk of spillage. Further studies are needed to evaluate reproducibility, oncologic safety, and long-term reproductive outcomes. Full article

Background/Objectives: Distal cholangiocarcinoma is a rare biliary tract cancer typically treated with pancreaticoduodenectomy. Comparative evidence specifically addressing minimally invasive versus open pancreaticoduodenectomy for this disease remains scarce. Methods: We conducted an updated systematic review and pairwise meta-analysis of comparative studies limited to distal cholangiocarcinoma. Binary outcomes were summarized as odds ratios, continuous outcomes as mean differences, and overall survival as hazard ratios. The primary survival analysis included only directly reported hazard ratios from prespecified matched or weighted cohorts; hazard ratios reconstructed from Kaplan–Meier curves were examined only in sensitivity analyses. Results: Six retrospective comparative studies involving 1623 patients met the inclusion criteria. Minimally invasive surgery was associated with lower blood loss (mean difference, −104.93 mL; 95% CI, −145.30 to −64.57; I² = 16.3%). No clear differences were found in clinically relevant postoperative pancreatic fistula (odds ratio, 1.03; 95% CI, 0.85 to 1.25), major morbidity (odds ratio, 0.96; 95% CI, 0.64 to 1.43), or R0 resection (odds ratio, 1.22; 95% CI, 0.96 to 1.56). In the primary overall survival analysis based on directly reported hazard ratios, the pooled hazard ratio was 0.93 (95% CI, 0.57 to 1.52; I² = 1.3%). In the sensitivity analysis incorporating eligible reconstructed hazard ratios, the pooled hazard ratio was 0.88 (95% CI, 0.73 to 1.05). In an exploratory recurrence-related survival family analysis based on directly reported estimates, the pooled hazard ratio was 0.95 (95% CI, 0.83 to 1.07; I² = 0.0%). Conclusions: Minimally invasive pancreaticoduodenectomy may reduce blood loss without clear evidence of worse major postoperative or oncologic outcomes in distal cholangiocarcinoma. However, the available evidence is entirely observational and should be interpreted with caution. Full article

Disparity estimation from stereo-endoscopic images is critical for 3D reconstruction in minimally invasive surgery (MIS). However, surgical environments have inherent interference factors including soft tissue deformation, motion blur, and photometric inconsistency. Currently, self-supervised generative networks such as StyleGAN offer an alternative method, but their reliance on iterative latent optimization leads to high computational latency and limits practical deployment. In this work, we propose a temporal latent prediction method to accelerate this optimization process. Instead of designing a brand new generator, our framework learns to predict an optimized initial latent vector, thereby reducing the number of optimization steps and per-frame inference time. Crucially, this prediction-guided mechanism does not alter the architecture or inference logic of the generator, ensuring the fidelity of reconstruction is comparable to that of the original method. Experiments on Phantom and In vivo datasets demonstrate that our method reduces average optimization steps by 16–59% and cuts per-frame latency by about 2.3×, compared to baseline predictors and initialization strategies. Importantly, the final photometric loss remains nearly identical across all methods, confirming that acceleration does not compromise reconstruction quality. These results position our approach as a practical step toward efficient, self-supervised stereo-endoscopic reconstruction in clinical settings. Full article

Accurate delineation of tumor margins is critical for complete resection and minimizing recurrence, yet existing imaging modalities such as MRI, CT, and fluorescence imaging suffer from limitations including high cost, limited accessibility, and intraoperative constraints. In this study, we propose a low-cost, non-invasive approach for subsurface imaging based on near-infrared (NIR) illumination combined with deep learning. A controlled experimental setup was developed in which structured patterns displayed on an electronic paper screen were concealed beneath a tissue-mimicking chicken phantom and imaged using a NIR-sensitive camera under halogen illumination. A convolutional autoencoder based on a U-Net architecture was trained on approximately 10,000 paired samples to reconstruct hidden structures from highly scattered surface images. The proposed method achieved strong reconstruction performance, with the best model reaching a peak signal-to-noise ratio (PSNR) of 20.14 dB, structural similarity index (SSIM) of 0.92, and feature similarity index (FSIM) of 0.94, significantly outperforming conventional Wiener filtering. Qualitative results demonstrated accurate recovery of subsurface shapes with minor smoothing artifacts. While generalization to out-of-distribution samples remains limited, the findings highlight the potential of combining NIR imaging and deep learning for safe, rapid, and cost-effective subsurface visualization. This work establishes a foundation for future development toward clinically relevant tumor margin detection. Full article