Current applications of artificial intelligence-based computer vision in laparoscopic surgery

Recent advances in artificial intelligence(AI)have sparked a surge in the application of computer vision(CV)in surgical video analysis.Laparoscopic surgery produces a large number of surgical videos,which provides a new opportunity for improving of CV technology in laparoscopic surgery.AI-based CV techniques may leverage these surgical video data to develop real-time automated decision support tools and surgeon training systems,which shows a new direction in dealing with the shortcomings of laparoscopic surgery.The effectiveness of CV applications in surgical procedures is still under early evaluation,so it is necessary to discuss challenges and obstacles.The review introduced the commonly used deep learning algorithms in CV and described their usage in detail in four application scenes,including phase recognition,anatomy detection,instrument detection and action recognition in laparoscopic surgery.The currently described applications of CV in laparoscopic surgery are limited.Most of the current research focuses on the identification of workflow and anatomical structure,while the identification of instruments and surgical actions is still awaiting further breakthroughs.Future research on the use of CV in laparoscopic surgery should focus on applications in more scenarios,such as surgeon skill assessment and the development of more efficient models.

Laparoscopic Cholecystectomy in Situs Inversus Totalis:a Case Report

SITUS inversus totalis is uncommon anatomic anomaly,with gallbladder on the left side.1Since the first known laparoscopic cholecystectomy in a patient with situs inversus has been reported by Campos and Sipes in 1991,2there have been only approximately 40cases of laparoscopic cholecystectomy performed in patients with situs inversus reported in the published literatures.3,4These cases may cause difficulties in the diagnostic and therapeutic management due to the mirror-image

A better way to do small-for-size liver transplantation in rats

Establishing a model for small-for-size liver transplantation is the basis for this study of partial and living donor graft liver transplantation.This study aims to explore a simpler and more effective way of establishing a 30%small-for-size liver transplantation in rats.Sprague-Dawley rats were selected as the donors and recipients.Small-for-size orthotopic liver transplantation was performed using Kamada’s two-cuff method.The donor’s liver was flushed via the abdominal aorta and hepatectomy was performed in situ.The animals were divided into three groups depending on the graft selected,with 40 pairs of rats in each group.In group Ⅰ,the median lobe of the liver was used as graft;in group Ⅱ,the right half of the median lobe and the right lobe were used as graft;and in group Ⅲ,the median and right lobes were used as graft.In groups Ⅰ and Ⅱ,the bodyweights of donors were the same as those of recipients;however,in group Ⅲ the bodyweights of donors were 100–120 g less than those of the recipients.The duration needed for transplantation,the 7-day survival rates,and the technical complication rates were compared among these three groups.The time required for hepatectomy was shorter in group Ⅲ compared with groups Ⅰ and II(8.8±0.7 min vs.11.5±1.1 min and 10.1±1.0 min,P=0.001).The cold ischemia time for the grafts,the anhepatic times,and the transplantation times for the recipients were not significantly different among the three groups.Compared with groups Ⅰ and Ⅱ,the incidence of bleeding,bile leakage,and inferior vena caval strictures were significantly decreased in group Ⅲ(P<0.05).No significant differences between the three groups were found based on other complications after the operation(P>0.05).Group Ⅲ had better 7-day survival rates and longer median survival times but the differences were not statistically significant.The method of small for donor bodyweight using the median and right lobes for grafting may be a more effective and simpler way of establishing a 30%small-for-size liver transplantation in rats,as shown by the shorter hepatectomy time and the occurrence of fewer complications after the operation.