Barriers to Clinical Academic Surgical Training and Career Development in the United Kingdom: A Review from the National Institute for Health and Care Research (NIHR) Advanced Surgical Technology Incubator (ASTI) Group.

Clinical academics play a vital role in advancing medical research, knowledge and treatments within the National Health System (NHS), but this career's sustainability is at risk due to barriers to accessing and pursuing research opportunities throughout a surgeon's training and career. Despite the diversification of surgical training with integrated opportunities, challenges such as limited training opportunities, lack of protected research time, and financial constraints persist. This paper from the National Institute for Health and Care Research (NIHR) Advanced Surgical Technology Incubator (ASTI) group highlights these issues, addressing the competitiveness of academic pathways, workload balance, mentorship importance, and the need for standardised assessments.

Protective ileostomy creation after anterior resection of the rectum (PICARR): a decision-making exploring international survey.

In our previous survey of experts, surgeon's decision-making process (DMP) about protective ileostomy (PI) creation after anterior resection was investigated. Based on our previous data, a multiple choice questionnaire has been developed. The aim is to perform a quantitative analysis of the results obtained from an international survey and to describe the clinical practice worldwide.

Determination of Westcott g-factors for the assay of non-1/v nuclides using k-NAA.

This study examines the impact of the Westcott g-factor on the concentration of elements like In, Ir, Re, Yb, Eu and Lu, measured using neutron capture reactions (n,γ), specifically focusing on those reactions, whose thermal neutron capture cross-sections (σ ) deviate from the conventional '1/v' behaviour. These measurements are quantified using k₀-based neutron activation analysis. The Westcott g-factor for the non-1/v nuclides was calculated using the characterized neutron temperature (T) at PFTS irradiation channel of KAMINI reactor.

Assessing rare earth elements in Indian coal ash using Westcott formalism in NAA and leaching studies.

This study employs Westcott formalism coupled with the internal monostandard approach in -NAA to assess Rare Earth Elements (REEs) in Indian coal ash samples. This method mitigates neutron flux perturbations during irradiation and enables detector efficiency calibration for quantitative analysis. Deviations in thermal capture cross-sections for non-1/ nuclides in REEs were addressed using the Westcott ( )-factor obtained from the ENDF/B-VIII.

Clinical applications of handheld robotic devices in general surgery: A mini-review.

Laparoscopy has evolved the surgical field around the world. Although this has defined minimally invasive surgery, there are limitations. Lack of articulating instrument tips restricts their use in difficult cases.

Exhaled volatile organic compounds in the detection of colorectal cancer: a systematic review and meta-analysis.

There is an apparent need for novel non-invasive colorectal cancer (CRC) screening tests that are more acceptable to patients and can reliably detect CRC or reduce the number of unnecessary colonoscopies performed in cancer-free patients. An emerging number of studies demonstrate the potential value of exhaled volatile organic compounds (VOCs) as a diagnostic and triaging test for CRC. A systematic appraisal and meta-analysis of the published evidence was done to determine whether exhaled VOCs can be used in the detection and screening of CRC.

Preoperative tumor marking with indocyanine green (ICG) prior to minimally invasive colorectal cancer: a systematic review of current literature.

Aim: To describe the currently available evidence regarding the efficacy and safety of preoperative tumor marking using indocyanine green (ICG) prior to laparoscopic or robotic colorectal resections.

Methods: A systematic search for relevant studies was conducted using the following databases: Embase (OVID), MEDLINE® (OVID), APA PsycInfo (OVID), Global Health (OVID) and HMIC Health Management Information Consortium (OVID) through June 2022 reported according to PRISMA 2020 guidelines. Primary outcome was the detection rate of the tumor sites preoperatively marked with ICG.

Simultaneous resection of colorectal cancer and synchronous liver metastases: what determines the risk of unfavorable outcomes? An international multicenter retrospective cohort study.

Background: The use of a simultaneous resection (SIMR) in patients with synchronous colorectal liver metastases (sCRLM) has increased over the past decades. However, it remains unclear when a SIMR is beneficial and when it should be avoided. The aim of this retrospective cohort study was therefore to compare the outcomes of a SIMR for sCRLM in different settings, and to assess which factors are independently associated with unfavorable outcomes.

Global survey on the surgical management of patients affected by colorectal cancer with synchronous liver metastases: impact of surgical specialty and geographic region.

Background: Consensus on the best surgical strategy for the management of synchronous colorectal liver metastases (sCRLM) has not been achieved. This study aimed to assess the attitudes of surgeons involved in the treatment of sCRLM.

Methods: Surveys designed for colorectal, hepato-pancreato-biliary (HPB), and general surgeons were disseminated through representative societies.

Preoperative tumor marking with indocyanine green prior of robotic colorectal resections.

This prospective case-series study aimed to assess the usefulness of preoperative colonoscopic marking of colorectal tumors using Indocyanine Green (ICG) fluorescence in patients that underwent robotic surgical colorectal resections. Consecutive patients that were eligible for colorectal resection with intent to cure in a single hospital (Athens Medical Center), from February 2022 to June 2022, were included. ICG solution was injected into the submucosal layer at 2 opposite sites (180 degrees apart) distal to the tumor, without submucosal elevation.

Radiochemical quality control of the radiopharmaceutical, SrCl produced in FBTR.

SrCl radiopharmaceuticals is mainly used for bone pain palliation in the cancer patients, is being produced in FBTR via Y(n, p)Sr using yttria target. The irradiated yttria target is chemically processed in high pure quartz distilled nitric acid medium in hot cell facility, to avoid the corrosion of components of hotcell due to chloride ions while using HCl medium. Being ionic species, the purified Sr(II) cation in aqueous solution containing bulk nitrate and other trace anions, exists as SrX species where X: F, Cl, Br, NO, PO and SO, n: stoichiometric anion content.

Use of fluorescence imaging and indocyanine green during colorectal surgery: Results of an intercontinental Delphi survey.

Background: Fluorescence imaging with indocyanine green is increasingly being used in colorectal surgery to assess anastomotic perfusion, and to detect sentinel lymph nodes.

Methods: In this 2-round, online, Delphi survey, 35 international experts were asked to vote on 69 statements pertaining to patient preparation and contraindications to fluorescence imaging during colorectal surgery, indications, technical aspects, potential advantages/disadvantages, and effectiveness versus limitations, and training and research. Methodological steps were adopted during survey design to minimize risk of bias.

Interobserver Variability in the Assessment of Fluorescence Angiography in the Colon.

Background: Fluorescence angiography in colorectal surgery is a technique that may lead to lower anastomotic leak rates. However, the interpretation of the fluorescent signal is not standardised and there is a paucity of data regarding interobserver agreement. The aim of this study is to assess interobserver variability in selection of the transection point during fluorescence angiography before anastomosis.

Effects of nerve-sparing procedures on surgical margins after robot-assisted radical prostatectomy.

Background: Nerve-sparing (NS) techniques could potentially increase positive surgical margins after robot-assisted radical prostatectomy (RARP). Nevertheless, the available studies have revealed ambiguous results among distinct groups. This study purposed to clarify the details of NS techniques to accurately estimate their influence on margin status.

Mapping the Mesentery Using ICG.

Indocyanine green (ICG) fluorescent imaging has been used in colorectal surgery to assess intraoperative blood flow to the colon. However, its use has expanded to allow imaging of the lymphatic drainage within the mesentery in cancer resections. This technique can been used for real-time visualization of lymph nodes, and the detection of sentinel lymph nodes, lateral sidewall nodes, metastatic lymph nodes, and peritoneal metastases.

A Delphi consensus statement for digital surgery.

The use of digital technology is increasing rapidly across surgical specialities, yet there is no consensus for the term 'digital surgery'. This is critical as digital health technologies present technical, governance, and legal challenges which are unique to the surgeon and surgical patient. We aim to define the term digital surgery and the ethical issues surrounding its clinical application, and to identify barriers and research goals for future practice.