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Background: Guidance technology in total joint arthroplasty has gained popularity over the last few decades. Computer-assisted navigation (CAN) was recently introduced for glenoid implantation in total shoulder arthroplasty (TSA). However, utilization trends of CAN TSA are not currently known. This study aims to determine the prevalence and trends of CAN usage in TSA from its introduction in 2017 until 2023.
Methods: A retrospective review was performed of all TSAs (anatomic TSA [aTSA] or reverse TSA [rTSA]) implanted using a single computer navigation shoulder system (ExactechGPS®; Gainesville, FL). Intraoperative navigation was performed for the glenoid component only. Use of CAN was reported per year to determine trends in the prevalence of CAN cases, number of users, new users, dropped users, high-volume users (>50 CAN cases/year), and the number of cases completed by high-volume users. The data were also stratified by type of TSA (aTSA vs. rTSA) and type of glenoid component used (augmented or nonaugmented).
Results: From 2017 to 2023, navigated TSAs increased from 654 to 9777 cases per year, with a greater increase in navigated rTSA than aTSA volume. The number of CAN cases using augmented implants grew 1435% whereas nonaugmented implants grew 1352%. By 2023, the overall number of CAN users increased from 79 to 667 users. High-volume CAN surgeons increased to 50 users by 2023. Over this period, the number of CAN TSA performed by high-volume surgeons increased more rapidly than the actual number of high-volume surgeons per year.
Conclusions: This study demonstrates an exponential increase in the use of CAN for TSA in the last 8 years. This increase is driven by progressive growth in both the volume of new users and CAN TSAs performed by existing users by several hundred folds. These upward trends in use of guidance technology for TSA are likely to continue in future.
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http://dx.doi.org/10.1016/j.jse.2025.01.015 | DOI Listing |
JTCVS Open
August 2025
Section of Thoracic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Mich.
Objectives: Laparoscopic (lap) paraesophageal hernia repair has excellent short-term outcomes but higher long-term recurrence rates compared with the transthoracic repair. We hypothesized that the robotic-assisted lap (robot) approach would have similarly good short-term outcomes as lap, but also lower recurrence rates.
Methods: A retrospective study of prospectively collected data was performed for paraesophageal hernia repairs at a single high-volume quaternary hospital from July 2018 to September 2022.
Objective: Minimally invasive aortic valve replacement (MIAVR) and transcatheter aortic valve replacement (TAVR) represent less-invasive alternatives to conventional surgical aortic valve replacement. In contrast to Society of Thoracic Surgeons (STS) Database data revealing <10% of all surgical aortic valve replacement procedures are performed via a minimally invasive approach, our center performs a high volume of MIAVR procedures. This propensity-score matched study aims to compare the outcomes of MIAVR versus TAVR in low-risk patients (STS Predicted Risk of Mortality <4%).
View Article and Find Full Text PDFPurpose: Robotic-assisted total knee arthroplasty (RA-TKA), which is increasingly used to improve surgical precision, can face adoption difficulties due to a learning curve marked by longer operating times. The aim of this study was to evaluate the learning curve associated with the VELYS™ robot in five surgeons from the same centre with different annual arthroplasty volumes using navigated assistance with personalised alignment. The primary aim was to assess the learning curve for each surgeon.
View Article and Find Full Text PDFInnovations (Phila)
September 2025
Division of Thoracic Surgery, Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Objective: This study evaluates the impact of transitioning from video-assisted thoracoscopic surgery (VATS) to robot-assisted thoracoscopic surgery (RATS) on patient outcomes and costs, based on the experience of a single surgeon at a quaternary center.
Methods: We reviewed patients who underwent anatomic lung resections by a single surgeon between 2015 and 2022, excluding nonanatomic resections and those involving robotic bronchoscopy followed by resection. We compared baseline characteristics, short-term outcomes, and costs between the VATS (2015 to 2018) and robotic (2018 to 2022) groups.
Oral Maxillofac Surg Clin North Am
September 2025
Division of Health Affairs, Department of Surgery, School of Medicine, Wayne State University, Senior Vice President's Office, 656 W. Kirby Street, Detroit, MI 48202, USA. Electronic address:
Oral and maxillofacial surgeons at research-intensive (Carnegie R1) institutions increasingly operate inside complex, consolidated academic health systems that demand leaders fluent in both operative realities and multibillion-dollar enterprise economics. This article provides a pragmatic roadmap for surgeons who intend to transition from high-volume operator to senior executive (eg, chief medical officer, system president, provost, or similar). Drawing on current models of mission-aligned funds flow, the author demonstrates how transparent blends of productivity incentives, protected teaching/research blocks, quality holdbacks, and small innovation pools can strengthen retention, extramural funding growth, and trust when the underlying formulas are openly shared.
View Article and Find Full Text PDF