Rapid, minimally invasive adult voluntary male circumcision: A randomised trial

Abstract Background Simulation-based practice has become increasingly important in minimally invasive surgery (MIS) training. Nevertheless, personnel resources for demonstration and mentoring simulation-based practice are limited. Video tutorials could be a useful tool to overcome this dilemma. However, the effect of video tutorials on MIS training and improvement of MIS skills is unclear. Methods A prospective randomised trial (n = 24 MIS novices) was conducted. A video-trainer with three different tasks (#1 – 3) was used for standardised goal-directed MIS training. The subjects were randomised to two groups with standard instructional videos (group A, n = 12) versus comprehensive video tutorials for each training task watched at specific times of repetition (group B, n = 12). Performance was analysed using the MISTELS score. At the beginning and following the curriculum, an MIS cholecystectomy (CHE) was performed on a porcine organ model and analysed using the GOALS score. After 18 weeks, participants performed 10 repetitions of tasks #1 – 3 for follow-up analysis. Results More participants completed tasks #1 and #2 in group B (83.3 and 75%) than in group A (66.7 and 50%, ns). For task #2, there was a significant improvement in precision in group B (p < 0.001). For the entire cohort, the GOALS-Scores were 12.9 before and 18.9 after the curriculum (p < 0.001), with no significant difference between groups. Upon follow-up, 84.2% (task#1), 26.3% (task#2) and 100% (task#3) of MIS novices were able to reach the defined goals (A vs. B ns). There was a trend for a better MISTELS score in group B upon follow-up. Conclusions Standardised comprehensive video tutorials watched frequently throughout practice can significantly improve precision in MIC training. This aspect should be incorporated in MIS training.

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Minimally invasive, sutureless, adolescent male circumcision with topical anesthetic: a field trial of Unicirc, a single-use surgical instrument

Translational Andrology and Urology ◽

10.21037/tau.2019.12.16 ◽

2020 ◽

Vol 9 (2) ◽

pp. 516-522

Author(s):

Peter S. Millard ◽

Norman Goldstuck

Keyword(s):

Minimally Invasive ◽

Male Circumcision ◽

Field Trial ◽

Adolescent Male ◽

Surgical Instrument ◽

Topical Anesthetic ◽

Single Use

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Minimally invasive posterior approach in total hip arthroplasty. Prospective randomised trial

Anales del Sistema Sanitario de Navarra ◽

10.23938/assn.0541 ◽

2010 ◽

Vol 33 (2) ◽

Keyword(s):

Total Hip Arthroplasty ◽

Minimally Invasive ◽

Hip Arthroplasty ◽

Posterior Approach ◽

Randomised Trial ◽

Total Hip ◽

Prospective Randomised Trial

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Protocol of BRICS: Brazilian multicentric pragmatic randomised trial of surgical interventions for displaced diaphyseal clavicle fracture study: MIPO versus ORIF for the treatment of displaced midshaft clavicle fractures

BMJ Open ◽

10.1136/bmjopen-2021-052966 ◽

2021 ◽

Vol 11 (10) ◽

pp. e052966

Author(s):

Adriano Fernando Mendes Jr. ◽

Rodrigo Fleury Curado ◽

Jair Moreira Dias Jr. ◽

José Da Mota Neto ◽

Oreste Lemos Carrazzone ◽

...

Keyword(s):

Surgical Treatment ◽

Minimally Invasive ◽

Internal Fixation ◽

Open Reduction ◽

Skin Irritation ◽

Randomised Trial ◽

Implant Failure ◽

Minimally Invasive Osteosynthesis ◽

Non Union ◽

Clavicle Fractures

IntroductionFractures of the diaphysis of the clavicle are common; however, treatment guidelines for this condition are lacking. Surgery is associated with a lower risk of non-union and better functional outcomes but a higher risk of complications. Open reduction and internal fixation with plates and screws are the most commonly performed techniques, but they are associated with paraesthesia in the areas of incisions, extensive surgical exposure and high rates of implant removal. Minimally invasive techniques for treating these fractures have a lower rate of complications. The aim of this study is to evaluate which surgical treatment option (minimally invasive osteosynthesis or open reduction and internal fixation) has better prognosis in terms of complications and reoperations.Methods and analysisThe study proposed is a multicentric, pragmatic, randomised, open-label, superiority clinical trial between minimally invasive osteosynthesis and open reduction and internal fixation for surgical treatment of patients with displaced fractures of the clavicle shaft. In the proposed study, 190 individuals with displaced midshaft clavicle fractures, who require surgery as treatment, will be randomised. The assessment will occur at 2, 6, 12, 24 and 48 weeks, respectively. The primary outcome of the study will be the number of complications and reoperations. For sample size calculation, a moderate effective size between the techniques was considered in a two-tailed test, with 95% confidence and 90% power. Complications include cases of infection, hypertrophic scarring, non-union, refracture, implant failure, hypoesthesia, skin irritation and shoulder pain. Reoperations are defined as the number of surgeries for pseudoarthrosis, implant failure, infection and elective removal of the implant.Ethics and disseminationStudy approved by the institutional ethics committee (number 34249120.9.0000.5505—V.3). The results will be disseminated by publications in peer-reviewed journals and presentations in medical meetings.Trial registration numberRBR-3czz68)/UTN U1111-1257-8953.

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