[Entrustable professional activities-A paradigm shift in the surgical training from quantity to quality].

Background: Since the 2020 revision of the medical training regulations surgical training in Germany has been based on the acquisition of knowledge (cognitive and methodological competence) as well as experience and skills (practical competence). As in previous training catalogues, minimum numbers are defined for essential operations; however, these operation catalogues do not reflect the actual surgical competence of residents.

Objective: This paper highlights the current challenges faced by prospective surgeons.

3D vs. 2D-4 K: Performance and self-perception of laparoscopic novices in a randomized prospective teaching intervention using standard tasks and box trainers.

Objective: The use of three-dimensional (3D) laparoscopy in surgical practice and training has been an area of research and discussion. Studies have suggested that 3D vision can improve speed and precision compared to traditional two-dimensional (2D) displays, while other authors found no benefits on the learning curves of laparoscopic novices. Modern two-dimensional laparoscopy with a resolution of 3840 × 2160 pixels (2D-4 K) seems to improve laparoscopic view and helps learners orient without stereopsis.

Evaluation of the feasibility of a video-transmitted surgical ward round: a proof of concept study.

Background: Surgical ward rounds are key element to point-of-care interprofessional postoperative treatment and technical and communicational aspects are relevant for the patient's safety and satisfaction. Due to COVID-19 restrictions, the training opportunity of experiencing a face-to-face surgical ward round was massively hampered and thus, we developed a digital concept. This study aims to investigate the feasibility of video-transmitted ward rounds integrating surgical and communicational aspects with live streaming from wards.

Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer-a retrospective cohort study.

Purpose: Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative complication rate.

Methods: In this retrospective cohort study, data analysis of 1241 consecutive patients undergoing colorectal cancer surgery in an 11-year period was performed.

Early postoperative endoscopic evaluation of rectal anastomoses: a prospective cross-sectional study.

Background: Reported incidence of anastomotic leakage (AL) of rectal anastomoses is up to 29% with an overall mortality up to 12%. Nevertheless, there is no uniform evidence-based diagnostic procedure for early detection of AL. The objective of this prospective clinical trial was to demonstrate the diagnostic value of early postoperative flexible endoscopy for rectal anastomosis evaluation.

Evaluation of different setting configurations with a new developed telemedical interface of a parallel kinematic robotic system - An experimental development study.

Background: For development of a minimally invasive intracorporal micromanipulator, a master-slave telemanipulation system was required.

Methods: Different input positions for a tablet-based input device with a heads-up centred screen were evaluated. Personal preference was assessed using a questionnaire.

Reducing Degrees of Freedom in Surgical Suturing: Implications for Minimally Invasive Device Development-A Prospective Experimental Study.

Open surgery allows the use of all 6 degrees of freedom (DOF; x-y-z and roll-pitch-yaw), whereas laparoscopy requires working under limitation to 4 axes. We present a prospective experimental study evaluating translational and rotational DOF restriction in surgical suturing tasks. An experimental platform included a kinematic structure that limited the maneuverability of the surgical instruments.

Long-term results of the custom- made hip endoprostheses Evolution K® and Adaptiva®: A prospective cohort study.

The aim of our study is to evaluate clinical long-term results and determine changes in periprosthetic bone density of the custom-made hip prostheses Evolution-K and Adaptiva . Periprosthetic bone density were evaluated by means of DEXA (LunariDXA- Prodigy bone densitometer) with a long-term follow-up of 16 (15-18) years (Evolution-K) in 24 patients and 13 (13-15) years (Adaptiva) in 41 patients. Evolution- K had a survival rate of 92% and yielded 79/100 points in Harris Hip Score, a mediocre result.

Learning curves, potential and speed in training of laparoscopic skills: a randomised comparative study in a box trainer.

Background: The effectiveness of practical surgical training is characterised by an inherent learning curve. Decisive are individual initial starting capabilities, learning speed, ideal learning plateaus, and resulting learning potentials. The quantification of learning curves requires reproducible tasks with varied levels of difficulty.

[Value of laparoscopy in blunt and penetrating abdominal trauma-a systematic review].

Background: The range of indications for laparoscopic procedures has been continuously widened in recent years. At the same time, however, the diagnostic and therapeutic role of laparoscopy in the management of blunt and penetrating abdominal trauma remains controversial.

Methods: A systematic literature search was carried out in PubMed from 2008 to 2019 on the use of laparoscopy in blunt and penetrating abdominal trauma.

[Robotic Assisted Proctocolectomy with Ileal Pouch-Anal Anastomosis in a Case of Suspected Hereditary Polyposis].

Background: Various forms of hereditary polyposis have been described in the literature. Classical familial adenomatous polyposis (FAP) is a rare, autosomal dominantly inherited disease which is caused by a germline mutation in the adenomatous polyposis coli gene (APC). Patients with this diagnosis successively develop multiple polyps of the colon.

Novel box trainer for taTME - prospective evaluation among medical students.

Background: Transanal total mesorectal excision (taTME) has been subject to extensive research and increasing clinical application. It allows further reduction of trauma by accessing via a natural orifice. Manifold platforms and instruments have been introduced and heterogeneity in surgical techniques exists.

[First Robotic Assisted Resection of a Retrorectal Tailgut Cyst - Video Case Report of a 27-Year-Old Female Patient].

Purpose: Tailgut cysts are a rare form of retrorectal tumours. They are also referred to as cystic hamartomas and predominantly affect female patients. Malignant transformation is thought to occur in 2 - 10% of cases, but there is scant further evidence.

Evaluation of self-educational training methods to learn laparoscopic skills - a randomized controlled trial.

Background: Evaluation of two different self-educational methods (video assisted learning versus video assisted learning plus a nodal point operation primer) on learning laparoscopic suturing and intracorporal knotting.

Methods: Randomized controlled trial at the laparoscopic surgical training center, University of Tubingen with 45 surgical novices first year medical students being pretested for dexterity. After self-educational training for 90 min with either method (Group A: video assisted learning, Group B: video assisted learning plus a nodal point operation primer) participants had to perform five laparoscopic intracorporal knots.

Rapid thyroid nodule growth is not a marker for well-differentiated thyroid cancer.

Background: Rapid growth of thyroid nodules is described as being associated with thyroid cancer. The objective of the study was to determine how the growth rate of thyroid nodules during follow-up is associated with the risk of thyroid cancer.

Methods: Retrospective analysis of patients undergoing thyroid surgery for nodular disease and a repetitive preoperative ultrasound work-up of at least 6 months was done.

Diagnostic accuracy of hyperbilirubinaemia in anticipating appendicitis and its severity.

Background: Hyperbilirubinaemia is reported to be a positive predictor in diagnosing appendicitis and especially appendiceal perforation. We, therefore, analysed the diagnostic accuracy of serum bilirubin in anticipating appendicitis and its severity.

Methods: All consecutive patients undergoing appendectomy for suspected appendicitis from May 2009 to August 2011 were analysed.