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Search Results (926)

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Keywords = surgical efficiency

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9 pages, 440 KiB  
Article
Botulinum Neurotoxin A Injections in Spasmodic Entropion: A Clinical Retrospective Cohort Study
by Brigitte Girard, Fabienne Carré and Simon Begnaud
Toxins 2025, 17(8), 383; https://doi.org/10.3390/toxins17080383 (registering DOI) - 31 Jul 2025
Viewed by 65
Abstract
While surgical procedure has been considered as the golden standard treatment for spasmodic entropion, Botulinum Neurotoxin A can be indicated in the treatment of spasmodic entropion for fragile elderly patients. This retrospective cohort study included 50 outdoor patients treated for spasmodic entropion, for [...] Read more.
While surgical procedure has been considered as the golden standard treatment for spasmodic entropion, Botulinum Neurotoxin A can be indicated in the treatment of spasmodic entropion for fragile elderly patients. This retrospective cohort study included 50 outdoor patients treated for spasmodic entropion, for whom palpebral surgery was recused. The intent of the present study was to describe an alternative outdoor treatment, to detail precisely the Botulinum Neurotoxin (BoNT) treatment pattern, the dosage of BoNT needed, the frequency of re-injection, the efficiency and the complications encountered. Fifty patients, 87.9 years old in average (±14.3) have been injected with BoNT. The average total dosage of BoNT is 7.62 ± 1.38 units of Incobotulinum, 10.2 ± 1.03 units of Onabotulinum and 17.2 ± 1.33 Speywood-units of Abobotulinum. Spasmodic entropion resolved in 3 ± 2 days after the BT injection. The average for re-injection is every 4.25 ± 1.30 months. By adjusting age and total dose, we have not been able to show any statistically significant relationship between time needed for re-injection and type of botulinum toxin A (p = 0.59). Patients with spasmodic entropion have responded significantly to BoNT injection. No systemic complications have been reported in this study. BoNT treatment is safe and effective for fragile elderly patients with spasmodic entropion and can be proposed instead of surgery or while waiting for their procedure. Full article
(This article belongs to the Special Issue Application of Botulinum Toxin in Facial Diseases)
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14 pages, 814 KiB  
Article
Impact of Corneal-Hydration-Induced Changes in Ablation Efficiency During Refractive Surgery
by Samuel Arba Mosquera and Shwetabh Verma
Photonics 2025, 12(8), 769; https://doi.org/10.3390/photonics12080769 - 30 Jul 2025
Viewed by 152
Abstract
(1) Background: A decrease in corneal hydration during refractive surgery is observed clinically as well as in laboratory settings, but the associated consequences are not yet fully understood. The purpose of this paper is to analyze the impact of the gain of ablation [...] Read more.
(1) Background: A decrease in corneal hydration during refractive surgery is observed clinically as well as in laboratory settings, but the associated consequences are not yet fully understood. The purpose of this paper is to analyze the impact of the gain of ablation efficiency due to hydration changes during cornea refractive surgery. (2) Methods: We developed a simulation model to evaluate the influence of hydration changes on the ablation algorithms used in laser refractive surgery. The model simulates different physical effects of an entire surgical process, simulating the shot-by-shot ablation process based on a modeled beam profile. The model considers corneal hydration, as well as environmental humidity, along with the laser beam characteristics and ablative spot properties for evaluating any hydration changes and their effect on laser refractive surgery. (3) Results: Using pulse lists collected from actual treatments, we simulated the gain of efficiency during the ablation process. Ablation efficiency is increased due to dehydration effects during laser treatments. Longer treatments suffer larger dehydration effects and are more prone to overcorrections due to gain of efficiency than shorter treatments. (4) Conclusions: The improper use of a model that overestimates or underestimates the effects derived from the hydration dynamics during treatment may result in suboptimal refractive corrections. This model may contribute to improving emmetropization and the correction of ocular aberrations with improved laser parameters that can compensate for the changes in ablation efficiency due to hydration changes in the cornea. Full article
(This article belongs to the Special Issue Advances and Applications in Visual Optics)
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16 pages, 1758 KiB  
Case Report
3D Printing Today, AI Tomorrow: Rethinking Apert Syndrome Surgery in Low-Resource Settings
by Maria Bajwa, Mustafa Pasha and Zafar Bajwa
Healthcare 2025, 13(15), 1844; https://doi.org/10.3390/healthcare13151844 - 29 Jul 2025
Viewed by 175
Abstract
Background/Objectives: This case study presents the first documented use of a low-cost, simulated, patient-specific three-dimensional (3D) printed model to support presurgical planning for an infant with Apert syndrome in a resource-limited setting. The primary objectives are to (1) demonstrate the value of 3D [...] Read more.
Background/Objectives: This case study presents the first documented use of a low-cost, simulated, patient-specific three-dimensional (3D) printed model to support presurgical planning for an infant with Apert syndrome in a resource-limited setting. The primary objectives are to (1) demonstrate the value of 3D printing as a simulation tool for preoperative planning in low-resource environments and (2) identify opportunities for future AI-enhanced simulation models in craniofacial surgical planning. Methods: High-resolution CT data were segmented using InVesalius 3, with mesh refinement performed in ANSYS SpaceClaim (version 2021). The cranial model was fabricated using fused deposition modeling (FDM) on a Creality Ender-3 printer with Acrylonitrile Butadiene Styrene (ABS) filament. Results: The resulting 3D-printed simulated model enabled the surgical team to assess cranial anatomy, simulate incision placement, and rehearse osteotomies. These steps contributed to a reduction in operative time and fewer complications during surgery. Conclusions: This case demonstrates the value of accessible 3D printing as a simulation tool in surgical planning within low-resource settings. Building on this success, the study highlights potential points for AI integration, such as automated image segmentation and model reconstruction, to increase efficiency and scalability in future 3D-printed simulation models. Full article
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21 pages, 14138 KiB  
Case Report
Multi-Level Oncological Management of a Rare, Combined Mediastinal Tumor: A Case Report
by Vasileios Theocharidis, Thomas Rallis, Apostolos Gogakos, Dimitrios Paliouras, Achilleas Lazopoulos, Meropi Koutourini, Myrto Tzinevi, Aikaterini Vildiridi, Prokopios Dimopoulos, Dimitrios Kasarakis, Panagiotis Kousidis, Anastasia Nikolaidou, Paraskevas Vrochidis, Maria Mironidou-Tzouveleki and Nikolaos Barbetakis
Curr. Oncol. 2025, 32(8), 423; https://doi.org/10.3390/curroncol32080423 - 28 Jul 2025
Viewed by 188
Abstract
Malignant mediastinal tumors are a group representing some of the most demanding oncological challenges for early, multi-level, and successful management. The timely identification of any suspicious clinical symptomatology is urgent in achieving an accurate, staged histological diagnosis, in order to follow up with [...] Read more.
Malignant mediastinal tumors are a group representing some of the most demanding oncological challenges for early, multi-level, and successful management. The timely identification of any suspicious clinical symptomatology is urgent in achieving an accurate, staged histological diagnosis, in order to follow up with an equally detailed medical therapeutic plan (interventional or not) and determine the principal goals regarding efficient overall treatment in these patients. We report a case of a 24-year-old male patient with an incident-free prior medical history. An initial chest X-ray was performed after the patient reported short-term, consistent moderate chest pain symptomatology, early work fatigue, and shortness of breath. The following imaging procedures (chest CT, PET-CT) indicated the presence of an anterior mediastinal mass (meas. ~11 cm × 10 cm × 13 cm, SUV: 8.7), applying additional pressure upon both right heart chambers. The Alpha-Fetoprotein (aFP) blood levels had exceeded at least 50 times their normal range. Two consecutive diagnostic attempts with non-specific histological results, a negative-for-malignancy fine-needle aspiration biopsy (FNA-biopsy), and an additional tumor biopsy, performed via mini anterior (R) thoracotomy with “suspicious” cellular gatherings, were performed elsewhere. After admission to our department, an (R) Video-Assisted Thoracic Surgery (VATS) was performed, along with multiple tumor biopsies and moderate pleural effusion drainage. The tumor’s measurements had increased to DMax: 16 cm × 9 cm × 13 cm, with a severe degree of atelectasis of the Right Lower Lobe parenchyma (RLL) and a pressure-displacement effect upon the Superior Vena Cava (SVC) and the (R) heart sinus, based on data from the preoperative chest MRA. The histological report indicated elements of a combined, non-seminomatous germ-cell mediastinal tumor, posthuberal-type teratoma, and embryonal carcinoma. The imminent chemotherapeutic plan included a “BEP” (Bleomycin®/Cisplatin®/Etoposide®) scheme, which needed to be modified to a “VIP” (Cisplatin®/Etoposide®/Ifosfamide®) scheme, due to an acute pulmonary embolism incident. While the aFP blood levels declined, even reaching normal measurements, the tumor’s size continued to increase significantly (DMax: 28 cm × 25 cm × 13 cm), with severe localized pressure effects, rapid weight loss, and a progressively worsening clinical status. Thus, an emergency surgical intervention took place via median sternotomy, extended with a complementary “T-Shaped” mini anterior (R) thoracotomy. A large, approx. 4 Kg mediastinal tumor was extracted, with additional RML and RUL “en-bloc” segmentectomy and partial mediastinal pleura decortication. The following histological results, apart from verifying the already-known posthuberal-type teratoma, indicated additional scattered small lesions of combined high-grade rabdomyosarcoma, chondrosarcoma, and osteosarcoma, as well as numerous high-grade glioblastoma cellular gatherings. No visible findings of the previously discovered non-seminomatous germ-cell and embryonal carcinoma elements were found. The patient’s postoperative status progressively improved, allowing therapeutic management to continue with six “TIP” (Cisplatin®/Paclitaxel®/Ifosfamide®) sessions, currently under his regular “follow-up” from the oncological team. This report underlines the importance of early, accurate histological identification, combined with any necessary surgical intervention, diagnostic or therapeutic, as well as the appliance of any subsequent multimodality management plan. The diversity of mediastinal tumors, especially for young patients, leaves no place for complacency. Such rare examples may manifest, with equivalent, unpredictable evolution, obliging clinical physicians to stay constantly alert and not take anything for granted. Full article
(This article belongs to the Section Thoracic Oncology)
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17 pages, 13125 KiB  
Article
Evaluating the Accuracy and Repeatability of Mobile 3D Imaging Applications for Breast Phantom Reconstruction
by Elena Botti, Bart Jansen, Felipe Ballen-Moreno, Ayush Kapila and Redona Brahimetaj
Sensors 2025, 25(15), 4596; https://doi.org/10.3390/s25154596 - 24 Jul 2025
Viewed by 403
Abstract
Three-dimensional imaging technologies are increasingly used in breast reconstructive and plastic surgery due to their potential for efficient and accurate preoperative assessment and planning. This study systematically evaluates the accuracy and consistency of six commercially available 3D scanning applications (apps)—Structure Sensor, 3D Scanner [...] Read more.
Three-dimensional imaging technologies are increasingly used in breast reconstructive and plastic surgery due to their potential for efficient and accurate preoperative assessment and planning. This study systematically evaluates the accuracy and consistency of six commercially available 3D scanning applications (apps)—Structure Sensor, 3D Scanner App, Heges, Polycam, SureScan, and Kiri—in reconstructing the female torso. To avoid variability introduced by human subjects, a silicone breast mannequin model was scanned, with fiducial markers placed at known anatomical landmarks. Manual distance measurements were obtained using calipers by two independent evaluators and compared to digital measurements extracted from 3D reconstructions in Blender software. Each scan was repeated six times per application to ensure reliability. SureScan demonstrated the lowest mean error (2.9 mm), followed by Structure Sensor (3.0 mm), Heges (3.6 mm), 3D Scanner App (4.4 mm), Kiri (5.0 mm), and Polycam (21.4 mm), which showed the highest error and variability. Even the app using an external depth sensor (Structure Sensor) showed no statistically significant accuracy advantage over those using only the iPad’s built-in camera (except for Polycam), underscoring that software is the primary driver of performance, not hardware (alone). This work provides practical insights for selecting mobile 3D scanning tools in clinical workflows and highlights key limitations, such as scaling errors and alignment artifacts. Future work should include patient-based validation and explore deep learning to enhance reconstruction quality. Ultimately, this study lays the foundation for more accessible and cost-effective 3D imaging in surgical practice, showing that smartphone-based tools can produce clinically useful scans. Full article
(This article belongs to the Special Issue Biomedical Imaging, Sensing and Signal Processing)
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12 pages, 549 KiB  
Systematic Review
Emerging Technologies in the Treatment of Orbital Floor Fractures: A Systematic Review
by Lorena Helgers, Ilze Prikule, Girts Salms and Ieva Bagante
Medicina 2025, 61(8), 1330; https://doi.org/10.3390/medicina61081330 - 23 Jul 2025
Viewed by 197
Abstract
Background and Objectives: Orbital floor fractures are challenging to treat, due to the complex orbital anatomy and limited surgical access. Emerging technologies—such as virtual surgical planning (VSP), 3D printing, patient-specific implants (PSIs), and intraoperative navigation—offer promising advancements to improve the surgical precision [...] Read more.
Background and Objectives: Orbital floor fractures are challenging to treat, due to the complex orbital anatomy and limited surgical access. Emerging technologies—such as virtual surgical planning (VSP), 3D printing, patient-specific implants (PSIs), and intraoperative navigation—offer promising advancements to improve the surgical precision and clinical outcomes. This review systematically evaluates and synthesizes current technological modalities with respect to their accuracy, operative duration, cost-effectiveness, and postoperative functional outcomes. Materials and Methods: A systematic review was conducted according to the PRISMA 2020 guidelines. The PubMed, Scopus, and PRIMO databases were searched for clinical studies published between 2019 and September 2024. Out of 229 articles identified, 9 met the inclusion criteria and were analyzed using the PICO framework. Results: VSP and 3D printing enhanced diagnostics and presurgical planning, offering improved accuracy and reduced planning time. Pre-bent PSIs shaped on 3D models showed superior accuracy, lower operative times, and better cost efficiency compared to intraoperative mesh shaping. Custom-designed PSIs offered high precision and clinical benefit but required a longer production time. Intraoperative navigation improved implant positioning and reduced the complication rates, though a detailed cost analysis remains limited. Conclusions: VSP, 3D printing, and intraoperative navigation significantly improve surgical planning and outcomes in orbital floor reconstruction. Pre-bent PSIs provide a time- and cost-effective solution with strong clinical performance. While customized PSIs offer accuracy, they are less practical in time-sensitive settings. Navigation systems are promising tools that enhance outcomes and may serve as an alternative to custom implants when time or resources are limited. Full article
(This article belongs to the Special Issue Craniomaxillofacial Surgery: Latest Innovations and Challenges)
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13 pages, 2559 KiB  
Article
An AI Approach to Markerless Augmented Reality in Surgical Robots
by Abhishek Shankar, Luay Jawad and Abhilash Pandya
Robotics 2025, 14(7), 99; https://doi.org/10.3390/robotics14070099 - 19 Jul 2025
Viewed by 281
Abstract
This paper examines the integration of markerless augmented reality (AR) within the da Vinci Surgical Robot, utilizing artificial intelligence (AI) for improved precision. The main challenge in creating AR for these systems is the small size (5 mm diameter) of the cameras used. [...] Read more.
This paper examines the integration of markerless augmented reality (AR) within the da Vinci Surgical Robot, utilizing artificial intelligence (AI) for improved precision. The main challenge in creating AR for these systems is the small size (5 mm diameter) of the cameras used. Traditional camera-calibration approaches produce significant errors when used for miniature cameras. Further, the use of external markers can be obstructive and inaccurate in dynamic surgical environments. The study focuses on overcoming these limitations of traditional AR methods by employing advanced neural networks for camera calibration and real-time image processing. We demonstrate the use of a dense neural network to reduce the total projection error by directly learning the mapping of a 3D point to a 2D image plane. The results show a median error of 7 pixels (1.4 mm) when using a neural network, as compared to an error of 50 pixels (10 mm) when using a more traditional approach involving camera calibration and robot kinematics. This approach not only enhances the accuracy of AR for surgical procedures but also offers a more seamless integration with existing robotic platforms. These research findings underscore the potential of AI in revolutionizing AR applications in medical robotics and other teleoperated systems, promising efficient and safer interventions. Full article
(This article belongs to the Section Medical Robotics and Service Robotics)
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12 pages, 2176 KiB  
Article
Technical Skill Acquisition in Pediatric Minimally Invasive Surgery: Evaluation of a 3D-Printed Simulator for Thoracoscopic Esophageal Atresia Repair
by Sara Maria Cravano, Annalisa Di Carmine, Chiara De Maio, Marco Di Mitri, Cristian Bisanti, Edoardo Collautti, Michele Libri, Simone D’Antonio, Tommaso Gargano, Enrico Ciardini and Mario Lima
Healthcare 2025, 13(14), 1720; https://doi.org/10.3390/healthcare13141720 - 17 Jul 2025
Viewed by 247
Abstract
Background: Minimally invasive surgery (MIS) is increasingly adopted in pediatric surgical practice, yet it demands specific technical skills that require structured training. Simulation-based education offers a safe and effective environment for skill acquisition, especially in complex procedures such as thoracoscopic repair of esophageal [...] Read more.
Background: Minimally invasive surgery (MIS) is increasingly adopted in pediatric surgical practice, yet it demands specific technical skills that require structured training. Simulation-based education offers a safe and effective environment for skill acquisition, especially in complex procedures such as thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA-TEF). Objective: This study aimed to evaluate the effectiveness of a 3D-printed simulator for training pediatric surgeons in thoracoscopic EA-TEF repair, assessing improvements in operative time and technical performance. Methods: A high-fidelity, 3D-printed simulator replicating neonatal thoracic anatomy was developed. Six pediatric surgeons at different training levels performed eight simulation sessions, including fistula ligation and esophageal anastomosis. Operative time and technical skill were assessed using the Stanford Microsurgery and Resident Training (SMaRT) Scale. Results: All participants showed significant improvements. The average operative time decreased from 115.6 ± 3.51 to 90 ± 6.55 min for junior trainees and from 100.5 ± 3.55 to 77.5 ± 4.94 min for senior trainees. The mean SMaRT score increased from 23.8 ± 3.18 to 38.3 ± 3.93. These results demonstrate a clear learning curve and enhanced technical performance after repeated sessions. Conclusions: Such 3D-printed simulation models represent an effective tool for pediatric MIS training. Even within a short time frame, repeated practice significantly improves surgical proficiency, supporting their integration into pediatric surgical curricula as an ethical, safe, and efficient educational strategy. Full article
(This article belongs to the Special Issue Contemporary Surgical Trends and Management)
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15 pages, 2173 KiB  
Review
Optimal Sites for Upper Extremity Amputation: Comparison Between Surgeons and Prosthetists
by Brandon Apagüeño, Sara E. Munkwitz, Nicholas V. Mata, Christopher Alessia, Vasudev Vivekanand Nayak, Paulo G. Coelho and Natalia Fullerton
Bioengineering 2025, 12(7), 765; https://doi.org/10.3390/bioengineering12070765 - 15 Jul 2025
Viewed by 331
Abstract
Upper extremity amputations significantly impact an individual’s physical capabilities, psychosocial well-being, and overall quality of life. The level at which an amputation is performed influences residual limb function, prosthetic compatibility, and long-term patient satisfaction. While surgical guidelines traditionally emphasize maximal limb preservation, prosthetists [...] Read more.
Upper extremity amputations significantly impact an individual’s physical capabilities, psychosocial well-being, and overall quality of life. The level at which an amputation is performed influences residual limb function, prosthetic compatibility, and long-term patient satisfaction. While surgical guidelines traditionally emphasize maximal limb preservation, prosthetists often advocate for amputation sites that optimize prosthetic fit and function, highlighting the need for a collaborative approach. This review examines the discrepancies between surgical and prosthetic recommendations for optimal amputation levels, from digit amputations to shoulder disarticulations, and explores their implications for prosthetic design, functionality, and patient outcomes. Various prosthetic options, including passive functional, body-powered, myoelectric, and hybrid devices, offer distinct advantages and limitations based on the level of amputation. Prosthetists emphasize the importance of residual limb length, not only for mechanical efficiency but also for achieving symmetry with the contralateral limb, minimizing discomfort, and enhancing control. Additionally, emerging technologies such as targeted muscle reinnervation (TMR) and advanced myoelectric prostheses are reshaping rehabilitation strategies, further underscoring the need for precise amputation planning. By integrating insights from both surgical and prosthetic perspectives, this review highlights the necessity of a multidisciplinary approach involving surgeons, prosthetists, rehabilitation specialists, and patients in the decision-making process. A greater emphasis on preoperative planning and interprofessional collaboration can improve prosthetic outcomes, reduce device rejection rates, and ultimately enhance the functional independence and well-being of individuals with upper extremity amputations. Full article
(This article belongs to the Section Biomedical Engineering and Biomaterials)
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14 pages, 633 KiB  
Article
Efficacy of Small Incision Cataract Surgery: A Multicenter Retrospective Study of Visual Outcomes in Coastal Ecuador
by Roberto Ernesto Alcívar-Viteri, Verónica Dolores Moreira-Pico, Carlos Iván Gómez-Cedeño, Julia Patricia Duran-Ospina, Aline Siteneski and Karime Montes-Escobar
Vision 2025, 9(3), 60; https://doi.org/10.3390/vision9030060 - 15 Jul 2025
Viewed by 534
Abstract
Cataracts remain one of the leading causes of reversible blindness in low- and middle-income countries such as Ecuador. This study assessed the efficacy of Small Incision Cataract Surgery (SICS) and analyzed sociodemographic and clinical factors associated with postoperative visual outcomes. A retrospective multicenter [...] Read more.
Cataracts remain one of the leading causes of reversible blindness in low- and middle-income countries such as Ecuador. This study assessed the efficacy of Small Incision Cataract Surgery (SICS) and analyzed sociodemographic and clinical factors associated with postoperative visual outcomes. A retrospective multicenter analysis was conducted across six ophthalmology clinics along the Ecuadorian coast between 2023 and 2024, including 558 patients aged 30 years or older. Postoperative visual acuity, measured using the LogMAR scale, improved significantly (mean improvement of 0.525 LogMAR units in the right eye (OD) and 0.489 LogMAR units in the left eye; p < 0.001). Ages between 60 and 69 years were associated with better outcomes in the right eye, while male sex was a protective factor against poor visual acuity in the left eye. Although diabetes mellitus and hypertension were prevalent, neither condition showed a significant association with postoperative visual outcomes. The findings confirm that SICS is a safe, effective, and cost-efficient surgical approach for restoring vision in resource-limited settings, supporting its inclusion in national public health strategies to reduce avoidable blindness in developing countries. Full article
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19 pages, 1293 KiB  
Review
Customized 3D-Printed Scaffolds for Alveolar Ridge Augmentation: A Scoping Review of Workflows, Technology, and Materials
by Saeed A. Elrefaei, Lucrezia Parma-Benfenati, Rana Dabaja, Paolo Nava, Hom-Lay Wang and Muhammad H. A. Saleh
Medicina 2025, 61(7), 1269; https://doi.org/10.3390/medicina61071269 - 14 Jul 2025
Viewed by 311
Abstract
Background and Objectives: Bone regeneration (BR) is a cornerstone technique in reconstructive dental surgery, traditionally using either barrier membranes, titanium meshes, or perforated non-resorbable membranes to facilitate bone regeneration. Recent advancements in 3D technology, including CAD/CAM and additive manufacturing, have enabled the development [...] Read more.
Background and Objectives: Bone regeneration (BR) is a cornerstone technique in reconstructive dental surgery, traditionally using either barrier membranes, titanium meshes, or perforated non-resorbable membranes to facilitate bone regeneration. Recent advancements in 3D technology, including CAD/CAM and additive manufacturing, have enabled the development of customized scaffolds tailored to patient needs, potentially overcoming the limitations of conventional methods. Materials and Methods: A scoping review was conducted according to the PRISMA guidelines. Electronic searches were performed in MEDLINE (PubMed), the Cochrane Library, Scopus, and Web of Science up to January 2025 to identify studies on digital technologies applied to bone augmentation. Eligible studies encompassed randomized controlled trials, cohort studies, case series, and case reports, all published in English. Data regarding digital workflows, software, materials, printing techniques, and sterilization methods were extracted from 23 studies published between 2015 and 2024. Results: The review highlights a diverse range of digital workflows, beginning with CBCT-based DICOM to STL conversion using software such as Mimics and Btk-3D®. Customized titanium meshes and other meshes like Poly Ether-Ether Ketone (PEEK) meshes were produced via techniques including direct metal laser sintering (DMLS), selective laser melting (SLM), and five-axis milling. Although titanium remained the predominant material, studies reported variations in mesh design, thickness, and sterilization protocols. The findings underscore that digital customization enhances surgical precision and efficiency in BR, with several studies demonstrating improved bone gain and reduced operative time compared to conventional approaches. Conclusions: This scoping review confirms that 3D techniques represent a promising advancement in BR. Customized digital workflows provide superior accuracy and support for BR procedures, yet variability in protocols and limited high-quality trials underscore the need for further clinical research to standardize techniques and validate long-term outcomes. Full article
(This article belongs to the Section Dentistry and Oral Health)
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13 pages, 771 KiB  
Article
The Anesthesiologic Impact of Single-Port Robot-Assisted Partial Nephrectomy: A Tertiary Referral Comparative Analysis Between Full-Flank Transperitoneal, Retroperitoneal, and Supine Lower Anterior Access (LAA)
by Luca Lambertini, Matteo Pacini, Paolo Polverino, Nikki R. Wilkinson, Ruben Sauer Calvo, Donato Cannoletta, Antony Angelo Pellegrino, Greta Pettenuzzo, Fabrizio Di Maida, Andrea Mari, Gabriele Bignante, Francesco Lasorsa, Alessandro Zucchi, Sergio Serni, Andrea Minervini, David B. Glick and Simone Crivellaro
J. Pers. Med. 2025, 15(7), 306; https://doi.org/10.3390/jpm15070306 - 11 Jul 2025
Viewed by 340
Abstract
Objective: To explore the impact of supine retroperitoneal single-port robot-assisted partial nephrectomy with lower anterior access on perioperative ventilatory, cardiovascular, and pain-related outcomes compared to a cohort of patients treated with single-port robot-assisted retroperitoneal or transperitoneal partial nephrectomy with standard flank patient positioning. [...] Read more.
Objective: To explore the impact of supine retroperitoneal single-port robot-assisted partial nephrectomy with lower anterior access on perioperative ventilatory, cardiovascular, and pain-related outcomes compared to a cohort of patients treated with single-port robot-assisted retroperitoneal or transperitoneal partial nephrectomy with standard flank patient positioning. Materials and Methods: Clinical and surgical data of all consecutive patients treated with single-port robot-assisted partial nephrectomy between March 2019 and January 2024 were prospectively collected and retrospectively analyzed. Specific same-day-discharge guidelines were applied to all cases. Failed same-day discharge was defined as the presence of early (<90 days) perioperative complications or the absence of opioid-free postoperative recovery. Results: Overall, 105 consecutive patients treated with single-port robot-assisted partial nephrectomy were analyzed. No differences emerged in baseline features. Peak inspiratory pressure and plateau pressure changes were significantly lower in the supine retroperitoneal lower anterior access group from the time of CO2 insufflation throughout every 30-min operative setpoint assessment (p = 0.02, p = 0.03, and p = 0.02, respectively). The transperitoneal group showed significantly higher values of mean, systolic, and diastolic blood pressure compared to retroperitoneal approaches. The supine lower anterior access group also showed significantly lower non-surgical operative room time, perioperative opioid administration, and postoperative median VAS pain score. Conclusions: The adoption of supine lower anterior access improved perioperative ventilatory, cardiovascular, and pain-related outcomes, also optimizing operating room efficiency. Further multicenter series with longer follow-ups are still needed to validate our preliminary results. Full article
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21 pages, 2346 KiB  
Article
Explainable Liver Segmentation and Volume Assessment Using Parallel Cropping
by Nitin Satpute, Nikhil B. Gaikwad, Smith K. Khare, Juan Gómez-Luna and Joaquín Olivares
Appl. Sci. 2025, 15(14), 7807; https://doi.org/10.3390/app15147807 - 11 Jul 2025
Viewed by 357
Abstract
Accurate liver segmentation and volume estimation from CT images are critical for diagnosis, surgical planning, and treatment monitoring. This paper proposes a GPU-accelerated voxel-level cropping method that localizes the liver region in a single pass, significantly reducing unnecessary computation and memory transfers. We [...] Read more.
Accurate liver segmentation and volume estimation from CT images are critical for diagnosis, surgical planning, and treatment monitoring. This paper proposes a GPU-accelerated voxel-level cropping method that localizes the liver region in a single pass, significantly reducing unnecessary computation and memory transfers. We integrate this pre-processing step into two segmentation pipelines: a traditional Chan-Vese model and a deep learning U-Net trained on the LiTS dataset. After segmentation, a seeded region growing algorithm is used for 3D liver volume assessment. Our method reduces unnecessary image data by an average of 90%, speeds up segmentation by 1.39× for Chan-Vese, and improves dice scores from 0.938 to 0.960. When integrated into U-Net pipelines, the post-processed dice score rises drastically from 0.521 to 0.956. Additionally, the voxel-based cropping approach achieves a 2.29× acceleration compared to state-of-the-art slice-based methods in 3D volume assessment. Our results demonstrate high segmentation accuracy and precise volume estimates with errors below 2.5%. This proposal offers a scalable, interpretable, efficient liver segmentation and volume assessment solution. It eliminates unwanted artifacts and facilitates real-time deployment in clinical environments where transparency and resource constraints are critical. It is also tested in other anatomical structures such as skin, lungs, and vessels, enabling broader applicability in medical imaging. Full article
(This article belongs to the Special Issue Image Processing and Computer Vision Applications)
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24 pages, 1616 KiB  
Systematic Review
Artificial Intelligence in Risk Stratification and Outcome Prediction for Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis
by Shayan Shojaei, Asma Mousavi, Sina Kazemian, Shiva Armani, Saba Maleki, Parisa Fallahtafti, Farzin Tahmasbi Arashlow, Yasaman Daryabari, Mohammadreza Naderian, Mohamad Alkhouli, Jamal S. Rana, Mehdi Mehrani, Yaser Jenab and Kaveh Hosseini
J. Pers. Med. 2025, 15(7), 302; https://doi.org/10.3390/jpm15070302 - 11 Jul 2025
Viewed by 522
Abstract
Background/Objectives: Transcatheter aortic valve replacement (TAVR) has been introduced as an optimal treatment for patients with severe aortic stenosis, offering a minimally invasive alternative to surgical aortic valve replacement. Predicting these outcomes following TAVR is crucial. Artificial intelligence (AI) has emerged as a [...] Read more.
Background/Objectives: Transcatheter aortic valve replacement (TAVR) has been introduced as an optimal treatment for patients with severe aortic stenosis, offering a minimally invasive alternative to surgical aortic valve replacement. Predicting these outcomes following TAVR is crucial. Artificial intelligence (AI) has emerged as a promising tool for improving post-TAVR outcome prediction. In this systematic review and meta-analysis, we aim to summarize the current evidence on utilizing AI in predicting post-TAVR outcomes. Methods: A comprehensive search was conducted to evaluate the studies focused on TAVR that applied AI methods for risk stratification. We assessed various ML algorithms, including random forests, neural networks, extreme gradient boosting, and support vector machines. Model performance metrics—recall, area under the curve (AUC), and accuracy—were collected with 95% confidence intervals (CIs). A random-effects meta-analysis was conducted to pool effect estimates. Results: We included 43 studies evaluating 366,269 patients (mean age 80 ± 8.25; 52.9% men) following TAVR. Meta-analyses for AI model performances demonstrated the following results: all-cause mortality (AUC = 0.78 (0.74–0.82), accuracy = 0.81 (0.69–0.89), and recall = 0.90 (0.70–0.97); permanent pacemaker implantation or new left bundle branch block (AUC = 0.75 (0.68–0.82), accuracy = 0.73 (0.59–0.84), and recall = 0.87 (0.50–0.98)); valve-related dysfunction (AUC = 0.73 (0.62–0.84), accuracy = 0.79 (0.57–0.91), and recall = 0.54 (0.26–0.80)); and major adverse cardiovascular events (AUC = 0.79 (0.67–0.92)). Subgroup analyses based on the model development approaches indicated that models incorporating baseline clinical data, imaging, and biomarker information enhanced predictive performance. Conclusions: AI-based risk prediction for TAVR complications has demonstrated promising performance. However, it is necessary to evaluate the efficiency of the aforementioned models in external validation datasets. Full article
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37 pages, 438 KiB  
Review
Three-Dimensionally Printed Splints in Dentistry: A Comprehensive Review
by Luka Šimunović, Samir Čimić and Senka Meštrović
Dent. J. 2025, 13(7), 312; https://doi.org/10.3390/dj13070312 - 10 Jul 2025
Viewed by 600
Abstract
Three-dimensional (3D) printing has emerged as a transformative technology in dental splint fabrication, offering significant advancements in customization, production speed, material efficiency, and patient comfort. This comprehensive review synthesizes the current literature on the clinical use, benefits, limitations, and future directions of 3D-printed [...] Read more.
Three-dimensional (3D) printing has emerged as a transformative technology in dental splint fabrication, offering significant advancements in customization, production speed, material efficiency, and patient comfort. This comprehensive review synthesizes the current literature on the clinical use, benefits, limitations, and future directions of 3D-printed dental splints across various disciplines, including prosthodontics, orthodontics, oral surgery, and restorative dentistry. Key 3D printing technologies such as stereolithography (SLA), digital light processing (DLP), and material jetting are discussed, along with the properties of contemporary photopolymer resins used in splint fabrication. Evidence indicates that while 3D-printed splints generally meet ISO standards for flexural strength and wear resistance, their mechanical properties are often 15–30% lower than those of heat-cured PMMA in head-to-head tests (flexural strength range 50–100 MPa vs. PMMA 100–130 MPa), and study-to-study variability is high. Some reports even show significantly reduced hardness and fatigue resistance in certain resins, underscoring material-specific heterogeneity. Clinical applications reviewed include occlusal stabilization for bruxism and temporomandibular disorders, surgical wafers for orthognathic procedures, orthodontic retainers, and endodontic guides. While current limitations include material aging, post-processing complexity, and variability in long-term outcomes, ongoing innovations—such as flexible resins, multi-material printing, and AI-driven design—hold promise for broader adoption. The review concludes with evidence-based clinical recommendations and identifies critical research gaps, particularly regarding long-term durability, pediatric applications, and quality control standards. This review supports the growing role of 3D printing as an efficient and versatile tool for delivering high-quality splint therapy in modern dental practice. Full article
(This article belongs to the Special Issue Digital Dentures: 2nd Edition)
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