Purpose: The robotic-assisted laparoscopic approach for creation of an appendicovesicostomy is in common practice now. We describe our modifications (“Gundeti’s 10 step modification”) to the conventional open technique for adopting the robotic-assisted laparoscopic Mitrofanoff appendicovesicostomy (RALMA), and study our long-term outcomes. Materials and Methods: This was a retrospective review of prospectively collected data and electronic medical record review from 2008 to 2023. Children with failure to empty the bladder with normal bladder capacity who underwent RALMA incorporating our “Gundeti’s 10 step modification” were included. The demographic, clinical, and postoperative details were analyzed. All were followed up annually, to monitor the continence and redo surgery rates. Success was defined as postoperative stomal continence and failure was considered in those who underwent redo procedures. Results: Twenty-seven children were included with a mean age of 9.4 years. The mean hospitalization, estimated blood loss, and operative time were 5.27 days, 18.05 mL, and 236 minutes. The complications were suprafascial stenosis (11.1%), subfascial stenosis (3.7%), and channel incontinence (7.4%). Three children required redo procedures (11.1%). The mean follow-up was 69.41 months, and all 27 children are continent at the last follow-up (100.0%). Conclusions Our proposed modifications, i.e., “Gundeti’s 10 step modification” allows a success rate of 92.6% for continence and 89.0% based on redo surgery rates, thereby proving it to be a safe and feasible option amongst the paediatric population.

The effect of dental extraction on temporomandibular joint (TMJ) pain remains controversial in oral surgery practice and has important implications for treatment planning in patients with temporomandibular disorders (TMDs). This systematic review evaluated whether third molar or other dental extractions are associated with changes in TMJ pain or TMD symptoms compared with non-extraction or pre-extraction controls. A protocol-registered review was conducted in accordance with PRISMA 2020 guidelines. PubMed/MEDLINE, Cochrane Library, Scopus, Web of Science, ScienceDirect, Google Scholar, ClinicalTrials.gov, and Clinical Trials Registry–India were searched up to August 2025. Human studies enrolling patients with clinically diagnosed TMD and comparing extraction with non-extraction approaches were included. Primary outcomes were TMJ pain, function, and patient-reported quality of life. Risk of bias was assessed using RoB 2.0 and ROBINS-I/NOS, and random-effects meta-analysis with GRADE certainty assessment was performed when appropriate. Eight studies met inclusion criteria, of which six were included in quantitative synthesis. Dental extraction was associated with a significant reduction in TMJ pain or symptoms (pooled risk ratio/odds ratio=0.49; 95% confidence interval 0.31-0.66;P<0.00001; I 2 =34%) with low-to-moderate certainty of evidence. Dental extraction may reduce TMJ pain in selected patients; however, individualized clinical judgment and further high-quality randomized controlled trials are required.

Purpose: There is ongoing debate on the haemoglobin level at which red cell transfusion should be administered following surgery. This study aimed to evaluate the benefits of a restrictive blood transfusion strategy and assess potential adverse effects of anaemia in the immediate postoperative phase, determining whether a liberal transfusion approach still remains necessary. Materials and Methods: A randomized control trial compared two groups: Group 1, with a liberal blood transfusion strategy, and Group 2, with a restrictive blood transfusion protocol. Haemoglobin levels were measured on the 3rd and 12th postoperative days, and at 1-month follow-up. Clinical and functional evaluations were conducted at the 1-month follow-up. Results: There was no significant difference between the liberal and restrictive groups in 10 feet walking with support at 12 days and at 1 month. The restrictive group had a shorter hospital stay (17.57±4.66 days) compared to the liberal group (19.56±5.34 days). Incidence of surgical site infections were similar (4.0% in liberal, 2.0% in restrictive), and no mortalities were observed in either group at the 1-month follow-up. Conclusion Both liberal and restrictive transfusion strategies were similarly effective in terms of early postoperative mortality and functional mobility. However, patients in the liberal transfusion group had a significantly longer length of stay compared to the restrictive group. Leading us to conclude that a restrictive strategy is effective and beneficial for patients and hospitals provided there are no signs of anaemia or a haemoglobin drop below 8 g/dL.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.

Methods: This study included 36 patients with HGS in whom reduction, posterior instrumentation, and fusion were achieved with MIS– TLIF. They were evaluated for lower back pain and radicular pain, scaled by Visual Analog Scale (VAS) score. Erect radiographs were performed to calculate slip angle (SA) and sacropelvic and spinopelvic parameters preoperatively, postoperatively, and at each follow-up until 4 years. Results: This study identified 30 patients with grade III HGS and six patients with grade IV/V HGS. Spinopelvic parameters were unbalanced in 13 patients. Complete reduction was achieved in 24 patients, with end-stage reduction of grade I with adequate spinopelvic balance achieved in 12 patients. Intraoperative neuromonitoring demonstrated no loss of signals throughout the procedure in any of the patients. Excellent functional outcome was achieved with back pain as well as leg pain VAS score improvements postoperatively in all patients. No implant-related complications or pseudoarthrosis incidences were reported at long-term follow-up at 4 years. Conclusions MIS–TLIF for HGS is a specific solution for a complex pathology, enabling one to achieve an excellent clinical as well as radiological outcome.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.