Modified Target Angle as a Predictor of Success in Strabismus Management after Orbital Fracture

Surgery for strabismus secondary to orbital fracture reconstruction surgery has had low success rates and high reoperation rates due to its incomitant nature and complex underlying mechanisms. There has been no consensus as to which of the various methods for improving the surgical results are best. We proposed a modified target angle criteria that combined the regular target angle and a favorable Hess area ratio percentage (HAR%) threshold to evaluate surgical results within the first postoperative week and conducted a retrospective chart review. According to the criteria of the modified target angle at the first postoperative week, a total of 63 patients were divided into two groups: Group 1, patients who fulfilled the criteria (49 patients); and Group 2, those who did not (14 patients). Sex, type of fracture, and the use of porous polyethylene sheets and titanium mesh during reconstruction surgery were significantly different between the groups. Group 1 showed a significantly higher percentage of patients who met the criteria of HAR% > 65% at the first week and >85% (i.e., a successful outcome) at the 6-month visit (p < 0.01). Additionally, Group 1 had a higher HAR% at the first postoperative week (p < 0.01). In conclusion, the patients meeting the criteria of the modified target angle at the first postoperative week had a favorable outcome at the 6-month visit in both ocular alignment and ocular movement.

BreastGAN: Artificial Intelligence-Enabled Breast Augmentation Simulation

Background Managing patient expectations is important to ensuring patient satisfaction in aesthetic medicine. To this end, computer technology developed to photograph, digitize, and manipulate three-dimensional (3D) objects has been applied to the female breast. However, the systems remain complex, physically cumbersome, and extremely expensive. Objectives The authors of the current study wish to introduce the plastic surgery community to BreastGAN, a portable, artificial intelligence-equipped tool trained on real clinical images to simulate breast augmentation outcomes. Methods Charts of all patients who underwent bilateral breast augmentation performed by the senior author were retrieved and analyzed. Frontal before and after images were collected from each patient’s chart, cropped in a standardized fashion, and used to train a neural network designed to manipulate before images to simulate a surgical result. AI-generated frontal after images were then compared to the real surgical results. Results Standardizing the evaluation of surgical results is a timeless challenge which persists in the context of AI-synthesized after images. In this study, AI-generated images were comparable to real surgical results. Conclusions This study features a portable, cost-effective neural network trained on real clinical images and designed to simulate surgical results following bilateral breast augmentation. Tools trained on a larger dataset of standardized surgical image pairs will be the subject of future studies.

Evaluation of the Postoperative Nursing Effect of Thoracic Surgery Assisted by Artificial Intelligence Robot

In order to evaluate the postoperative nursing effect of artificial intelligence robot-assisted thoracic surgery, this study proposed the Da Vinci robot-assisted pulmonary lobotomy, from January to December 2014; 42 patients (15 males and 27 females, aged 33–69 years old) underwent lobectomy with the Da Vinci robot system in the chest hospital. A series of postoperative nursing was carried out. The surgical results showed that 42 patients with Da Vinci robot-assisted lobectomy had operation time of 62–225 min and blood loss of 70–300 mL. There was no intraoperative blood transfusion, the intraoperative central rate was maintained at 60–100 times/min, and the blood pressure was maintained at 90–140/60–90 mmHg. No patient was transferred to thoracotomy, and 2 patients were performed robotic wedge resection first, and then, robotic lobectomy was performed after malignant tumor was confirmed by freezing results, with relatively light postoperative pain, no infection, beautiful wound, and smooth recovery and discharge. Robot-assisted lobectomy is a new technique with advantages of less trauma, less pain, faster recovery, and safer and more thorough lymph node dissection.

Health insurance policy on surgical treatment of adult spinal deformity

Background: Recent burgeoning research on adult spinal deformity (ASD) has unveiled the benefits of surgical treatment and how to gain the benefits although these have only been around for 10 years.Current Concepts: During the last decade, the significance of pelvic incidence in the global spinal sagittal alignment and introductions of the Scoliosis Research Society-Schwab classification for ASD have been the guidelines of surgical treatment for ASD and the milestones for promising surgical results. However, one of the unsolved problems for the surgical treatment of ASD is the proximal junctional kyphosis, for which multifactorial causative factors have been suggested. Recent studies have focused on dynamic natures in patients with ASD during daily activities, which might be a clue for both prevention of proximal junctional kyphosis and a better level of surgical results. Even though a recent remarkable advancement for surgical treatment for ASD is present, the national guideline for reimbursement is still following the surgical indication for lumbar degenerative kyphosis published in 1988.Discussion and Conclusion: A significant gap exists between the national reimbursement guideline and generally held surgical indication for ASD surgery. Consequently, this huge gap raises trouble in both patients and surgeons. The patients with ASD cannot take an appropriate surgery for ASD, while the spine surgeons experience unreasonable adjustment of the cost by the Health Insurance Review and Assessment Service.