3D-printed anatomical models for tactile teaching visually-impaired students

Development of three-dimensional printing technologies allowed educators to implement printed models in tactile teaching processes. This paper presents the case of 3D-printed models of body structures, including major body organs. Thanks to many possibilities of adjusting models details, they can be used in every stage of education. Realistic materials and high-detailed structures are much more effective in teaching in comparison to current approach, especially for visually impaired (VI) students.Jan Sylwester Witowsk

Porównanie operacji odbytnicy z pierwotnym zespoleniem wykonywanych laparoskopowo i z wykorzystaniem robota zabiegowego : przegląd systematyczny i metaanaliza

Cel: Rak odbytnicy jest jednym z najpowszechniejszych nowotworów przewodu pokarmowego. Złotym standardem pozostaje resekcja chirurgiczna, jednak jego leczenie wciąż budzi kontrowersje. Operacje z wykorzystaniem robota zabiegowego zyskują na popularności w porównaniu z technikami laparoskopowymi. Brakuje badań dotyczących resekcji odbytnicy z pierwotnym zespoleniem. Metody: Przeprowadzono przegląd systematyczny i metaanalizę zgodnie z wytycznymi PRISMA. Głównymi punktami końcowymi były: chorobowość i powikłania krótkoterminowe. Wyniki: Wstępnie przeszukano 1250 opublikowanych artykułów. Ostatecznie wybrano 6 badań przeprowadzonych na grupie 1580 chorych, które poddano analizie ilościowej. W naszym badaniu wykazaliśmy, że zarówno zabieg z wykorzystaniem robota chirurgicznego, jak i zabieg laparoskopowy, są równorzędne w odniesieniu do: zachorowalności (RR = 1,1; 95% CI: 0,89–1,39), liczby poważnych powikłań (RR = 1,01; 95% CI: 0,60–1,69) oraz długości hospitalizacji (MD = 0,15; 95% CI: -0,60–0,90). Wykazano również, że zabieg z wykorzystaniem robota chirurgicznego ma niewielką przewagę przy wycięciu mezorektum (RD = -0,19; 95% CI: -0,35–(-0,03). I2 = 69%) oraz wiąże się z mniejszą częstością nieszczelności zespolenia (OR = 2,25; 95% CI: 1,23–4,09; I2 = 0%). Wnioski: W niektórych przypadkach zabieg z użyciem robota chirurgicznego zapewnia radykalność resekcji oraz mniejsze prawdopodobieństwo nieszczelności zespolenia. Jednakże – ze względu na niejednorodność badań – otrzymane wyniki są niepewne. Potrzeba dalszych zrandomizowanych badań na dużych populacjach pacjentów.Purpose: Rectal cancer is one of the most common malignancies of the gastrointestinal tract. The gold standard method is surgical resection. The approach to rectal cancer is still controversial. Nowadays, robotic approach gains popularity in comparison to traditional laparoscopy. However, there is lack of studies assessing rectal resections with primary anastomosis. Methods: We performed a systematic review and meta-analysis according to the PRISMA guidelines. The primary outcomes of interest were morbidity and short-term complications. Results: An initial reference search yielded 1250 articles. Finally, we chose six studies covering 1580 patients that we included in the quantitative analysis. In our study, we demonstrated that laparoscopic and robotic surgery are non-inferior to one another in terms of morbidity (RR=1.1 95% CI: 0.89-1.39), major complication rate (RR=1.01, 95% CI: 0.60-1.69) or in length of hospitalization (MD=0,15 95% CI: -0.60−0.90). The latter has slight advantage in quality of mesorectal excision (RD = -0.19, 95% CI: -0.35 − -0.03. I2=69%) and anastomotic leakage rate (OR=2.25, 95% CI: 1.23-4.09, I2=0%). Conclusion: In certain cases Robotic Surgery provide better quality of resected specimen and lower leakage ratio, nevertheless due to heterogeneity the results are uncertain. There is substantial need for large randomized controlled studies

Investigating Risk Factors for Complications after Ileostomy Reversal in Low Anterior Rectal Resection Patients : an Observational Study

: Introduction: Defunctioning ileostomy has been widely used in patients undergoing low anterior rectal resection to reduce the rate of postoperative leakage. It is still not clear whether interval between primary procedure and ileostomy reversal has an impact on treatment outcomes. Methods: In our prospective observational study we reviewed 164 consecutive cases of patients who underwent total mesorectal excision with primary anastomosis. Univariate and multivariate regression models were used to search for risk factors for prolonged length of stay and complications after defunctioning ileostomy reversal. Receiver operating characteristic curves were utilized to set cut-off points for prolonged length of stay and perioperative morbidity. Results: In total, 132 patients were included in the statistical analysis. The median interval between primary procedure and defunctioning ileostomy reversal was 134 (range: 17–754) days, while median length of stay was 5 days (4–6 interquartile range (IQR)). Prolonged length of stay cut-off was established at 6 days. Regression models revealed that interval between primary surgery and stoma closure as well as complications after primary procedure are risk factors for complications after defunctioning ileostomy reversal. Prolonged length of stay has been found to be related primarily to interval between primary surgery and stoma closure. Conclusions: In our study interval between primary surgery and stoma closure along with complication occurrence after primary procedure are risk factors for perioperative morbidity and prolonged length of stay (LOS) after ileostomy reversal. The effort should be made to minimize the interval to ileostomy reversal. However, randomized studies are necessary to avoid the bias which appears in this observational study and confirm our findings