1.Research progress on the application of artificial intelligence in minimally invasive surgery
Longfei GOU ; Chang CHEN ; Bo′er SU ; Wenhao WU ; Haijun DENG ; Jiang YU ; Guoxin LI ; Yanfeng HU ; Hao CHEN
Chinese Journal of Digestive Surgery 2025;24(5):599-608
With the rapid development of minimally invasive techniques in surgery, arti-ficial intelligence (AI), particularly deep learning, is playing an increasingly important role in mini-mally invasive surgery. By automated analysis of surgical videos, AI can efficiently perform key tasks such as instrument recognition, surgical phase identification, action analysis, anatomical structure recognition, intraoperative diagnosis, adverse event monitoring and smart desmoking. These appli-cations provide essential support for real-time monitoring, surgical navigation and skill assessment during surgery. The authors summarize the current research progress of AI in minimally invasive surgery, including its applications in the fields of hepatobiliary and pancreatic surgery, as well as gastrointestinal surgery. It also explores the potential of AI in enhancing surgical safety, efficiency and skill assessment. By synthesizing the latest research achievements of AI technology in the field of surgery, as well as analyzing its technical challenges and risks, it aims to provide guidance for future innovations and clinical applications, promoting the advancement and implementation of AI in minimally invasive surgery.
2.Application and exploration of single-incision plus one port laparoscopic surgery in radical resection of colorectal cancer
Yu ZHU ; Hao WANG ; Yanan WANG ; Haijun DENG ; Tingyu MOU
Chinese Journal of Digestive Surgery 2025;24(6):733-738
The surgical management of colorectal cancer has evolved from conventional multiport laparoscopic surgery toward more minimally invasive and individualized approaches. Among these, single-incision laparoscopic surgery (SILS) or reduced-port laparoscopic surgery (RPLS) has gained increasing attention from clinicians. Single-incision plus one port laparoscopic surgery (SILS+1) combines the advantages of both SILS and RPLS. Recent studies have demonstrated that compared with conventional multiport laparoscopic surgery, SILS+1 could yield comparable safety, feasibility and oncologic outcomes in treating colorectal cancer while offering additional benefits in enhanced recovery and better cosmesis.The development of SILS+1 relies heavily on innovations in single-port platforms and specialized instruments. By strictly adhering to its indica-tions, skillfully employing string and traction techniques during surgery, and the appropriate mana-gement of complications such as hemorrhage, the procedure can be performed safely and smoothly. The authors review relevant domestic and international studies and integrate the practical experi-ence to provide an in-depth discussion on the application and exploration of SILS+1 in radical colorectal cancer surgery, aiming to provide valuable insights for broader adoption of this approach.
3.Clinical cure and safe drug withdrawal in chronic hepatitis B
Jieli HU ; Yewei JI ; Pai PENG ; Hui FAN ; Liuyang ZHAO ; Haijun DENG ; Ni TANG ; Ailong HUANG
Chinese Journal of Hepatology 2025;33(6):526-533
With the widespread implementation of immunoprophylaxis strategies, the primary challenge in HBV infection prevention and control in China has shifted to reducing the burden of existing infections. A crucial approach to decreasing the burden of existing infections is to develop the effective treatment methods to achieve clinical or functional cures within a limited treatment duration for infected patients. The existing infections can be divided into two parts: those that are easy to cure and those that are difficult to treat. Patients who meet the current drug withdrawal criteria and at the same time have HBsAg<100 IU/mL following treatment with nucelos(t)ide analogue therapy are the easier one to treat, accounting for about 12% of the total infections, and the remaining 88% are difficult to cure. A necessary step toward clinical cure is pushing the HBsAg levels of patients to <100 IU/mL, but this driving effect must stem from effective immune reconstitution against HBV. Recent prevention and control, certain characteristics and implementation of clinical cure, and the safe drug withdrawal are discussed here to offer new perspectives on issues related to hepatitis B.
4.Comparison of the application of video stylet and video laryngoscope in nasotracheal intubation in oral sur-gery
Manjun LI ; Leilei HU ; Haijun HU ; Jing ZHANG ; Shuchun YU ; Zhenzhong LUO ; Wei DENG
The Journal of Practical Medicine 2025;41(6):812-817
Objective This study aims to compare the efficacy of video stylets and video laryngoscopes in facilitating nasotracheal intubation during oral surgery.Methods A total of 80 patients,aged between 18 and 70 years old,with ASA grade Ⅰ or Ⅱ,scheduled for elective oral surgery under general anesthesia,were randomly assigned to either the video stylet group(Group N)or the video laryngoscope group(Group C),with 40 patients in each group.In Group N,a video stylet was used to shape the tracheal tube at a 90-degree angle,with the shaping position being the vertical distance from the Adam's apple to the nostril.The tube was inserted from the nasal cavity into the throat under direct visualization,and positioned behind the glottis.In Group C,the tube was initially blindly inserted into the nasal cavity without a core.Upon reaching the throat,a video laryngoscope was employed to lift the epiglottis and expose the glottis from the mouth.The tube was then inserted with the aid of intubation forceps or cuff inflation.The primary outcome measure was the intubation time.Additional measures included the time taken for nasal passage,glottis exposure,and the number of intubation attempts and assistant interventions required.Vital signs,including MAP and HR,were recorded at five minutes of quiet rest upon entering the room(T0),during glottis exposure(T1),upon passage of the tube through the glottis(T2),and one minute after the tube entered the trachea(T3).Complications such as epistaxis,oral mucosal bleeding,loose incisors,and postop-erative sore throat were also documented.Results The intubation time and nasal passage time in Group N were significantly shorter than those in Group C(P<0.05).The number of cuff inflations and intubation forceps assisted cases in Group N was significantly lower than in Group C(P<0.05).There were no significant differences between the two groups in terms of glottis exposure time,first successful intubation times,C-L glottis classification,and mandibular lift-assisted intubation(P>0.05).The increase in MAP and HR in Group N at T1 and T2 was signifi-cantly less than in Group C(P<0.05).The number of cases with mild epistaxis in Group N was significantly lower than in Group C(P<0.05).Similarly,the number of cases with loose incisors and oral mucosal bleeding in Group N was significantly less than in Group C(P<0.05).Conclusion Compared to the video laryngoscope,the video stylet-guided nasotracheal intubation results in a shorter intubation time,less damage to the oronasopharynx,eliminates the need for intubation forceps,and reduces the patient's stress and vascular stress response during intubation.
5.Comparison of the application of video stylet and video laryngoscope in nasotracheal intubation in oral sur-gery
Manjun LI ; Leilei HU ; Haijun HU ; Jing ZHANG ; Shuchun YU ; Zhenzhong LUO ; Wei DENG
The Journal of Practical Medicine 2025;41(6):812-817
Objective This study aims to compare the efficacy of video stylets and video laryngoscopes in facilitating nasotracheal intubation during oral surgery.Methods A total of 80 patients,aged between 18 and 70 years old,with ASA grade Ⅰ or Ⅱ,scheduled for elective oral surgery under general anesthesia,were randomly assigned to either the video stylet group(Group N)or the video laryngoscope group(Group C),with 40 patients in each group.In Group N,a video stylet was used to shape the tracheal tube at a 90-degree angle,with the shaping position being the vertical distance from the Adam's apple to the nostril.The tube was inserted from the nasal cavity into the throat under direct visualization,and positioned behind the glottis.In Group C,the tube was initially blindly inserted into the nasal cavity without a core.Upon reaching the throat,a video laryngoscope was employed to lift the epiglottis and expose the glottis from the mouth.The tube was then inserted with the aid of intubation forceps or cuff inflation.The primary outcome measure was the intubation time.Additional measures included the time taken for nasal passage,glottis exposure,and the number of intubation attempts and assistant interventions required.Vital signs,including MAP and HR,were recorded at five minutes of quiet rest upon entering the room(T0),during glottis exposure(T1),upon passage of the tube through the glottis(T2),and one minute after the tube entered the trachea(T3).Complications such as epistaxis,oral mucosal bleeding,loose incisors,and postop-erative sore throat were also documented.Results The intubation time and nasal passage time in Group N were significantly shorter than those in Group C(P<0.05).The number of cuff inflations and intubation forceps assisted cases in Group N was significantly lower than in Group C(P<0.05).There were no significant differences between the two groups in terms of glottis exposure time,first successful intubation times,C-L glottis classification,and mandibular lift-assisted intubation(P>0.05).The increase in MAP and HR in Group N at T1 and T2 was signifi-cantly less than in Group C(P<0.05).The number of cases with mild epistaxis in Group N was significantly lower than in Group C(P<0.05).Similarly,the number of cases with loose incisors and oral mucosal bleeding in Group N was significantly less than in Group C(P<0.05).Conclusion Compared to the video laryngoscope,the video stylet-guided nasotracheal intubation results in a shorter intubation time,less damage to the oronasopharynx,eliminates the need for intubation forceps,and reduces the patient's stress and vascular stress response during intubation.
6.Research progress on the application of artificial intelligence in minimally invasive surgery
Longfei GOU ; Chang CHEN ; Bo′er SU ; Wenhao WU ; Haijun DENG ; Jiang YU ; Guoxin LI ; Yanfeng HU ; Hao CHEN
Chinese Journal of Digestive Surgery 2025;24(5):599-608
With the rapid development of minimally invasive techniques in surgery, arti-ficial intelligence (AI), particularly deep learning, is playing an increasingly important role in mini-mally invasive surgery. By automated analysis of surgical videos, AI can efficiently perform key tasks such as instrument recognition, surgical phase identification, action analysis, anatomical structure recognition, intraoperative diagnosis, adverse event monitoring and smart desmoking. These appli-cations provide essential support for real-time monitoring, surgical navigation and skill assessment during surgery. The authors summarize the current research progress of AI in minimally invasive surgery, including its applications in the fields of hepatobiliary and pancreatic surgery, as well as gastrointestinal surgery. It also explores the potential of AI in enhancing surgical safety, efficiency and skill assessment. By synthesizing the latest research achievements of AI technology in the field of surgery, as well as analyzing its technical challenges and risks, it aims to provide guidance for future innovations and clinical applications, promoting the advancement and implementation of AI in minimally invasive surgery.
7.Application and exploration of single-incision plus one port laparoscopic surgery in radical resection of colorectal cancer
Yu ZHU ; Hao WANG ; Yanan WANG ; Haijun DENG ; Tingyu MOU
Chinese Journal of Digestive Surgery 2025;24(6):733-738
The surgical management of colorectal cancer has evolved from conventional multiport laparoscopic surgery toward more minimally invasive and individualized approaches. Among these, single-incision laparoscopic surgery (SILS) or reduced-port laparoscopic surgery (RPLS) has gained increasing attention from clinicians. Single-incision plus one port laparoscopic surgery (SILS+1) combines the advantages of both SILS and RPLS. Recent studies have demonstrated that compared with conventional multiport laparoscopic surgery, SILS+1 could yield comparable safety, feasibility and oncologic outcomes in treating colorectal cancer while offering additional benefits in enhanced recovery and better cosmesis.The development of SILS+1 relies heavily on innovations in single-port platforms and specialized instruments. By strictly adhering to its indica-tions, skillfully employing string and traction techniques during surgery, and the appropriate mana-gement of complications such as hemorrhage, the procedure can be performed safely and smoothly. The authors review relevant domestic and international studies and integrate the practical experi-ence to provide an in-depth discussion on the application and exploration of SILS+1 in radical colorectal cancer surgery, aiming to provide valuable insights for broader adoption of this approach.
8.Clinical cure and safe drug withdrawal in chronic hepatitis B
Jieli HU ; Yewei JI ; Pai PENG ; Hui FAN ; Liuyang ZHAO ; Haijun DENG ; Ni TANG ; Ailong HUANG
Chinese Journal of Hepatology 2025;33(6):526-533
With the widespread implementation of immunoprophylaxis strategies, the primary challenge in HBV infection prevention and control in China has shifted to reducing the burden of existing infections. A crucial approach to decreasing the burden of existing infections is to develop the effective treatment methods to achieve clinical or functional cures within a limited treatment duration for infected patients. The existing infections can be divided into two parts: those that are easy to cure and those that are difficult to treat. Patients who meet the current drug withdrawal criteria and at the same time have HBsAg<100 IU/mL following treatment with nucelos(t)ide analogue therapy are the easier one to treat, accounting for about 12% of the total infections, and the remaining 88% are difficult to cure. A necessary step toward clinical cure is pushing the HBsAg levels of patients to <100 IU/mL, but this driving effect must stem from effective immune reconstitution against HBV. Recent prevention and control, certain characteristics and implementation of clinical cure, and the safe drug withdrawal are discussed here to offer new perspectives on issues related to hepatitis B.
9.Induction of apoptosis in triple-negative breast cancer cells by petroleum ether extract of Sageretia thea
Zhihui FENG ; Yiqing DENG ; Bing YE ; Pei AN ; Hong ZHANG ; Haijun ZHANG
Journal of Pharmaceutical Practice and Service 2024;42(6):253-259
Objective To investigate the effect of the petroleum ether extract of Sageretia thea on the proliferation and apoptosis of breast cancer cells.Methods After breast cancer cells were incubated with the petroleum ether extract for different times,cell viability was analyzed by CCK8 assay,cell proliferation was detected by plate cloning test,nuclear morphology was observed by DAPI staining,mitochondrial membrane potential(MMP)and reactive oxygen species(ROS)were determined by immunofluorescence,and the cell cycle and apoptosis were detected by flow cytometry.After incubating with the extract for 24 h,the CCK8 assay was used to observe the toxicity to normal human vascular endothelial cells.Results The IC50 of BT549 and MDA-MB-231 breast cancer cell lines treated with the petroleum ether extract for 24 h were 45.40 μg/ml and 12.23 μg/ml,respectively.The extract time and dose dependently inhibited breast cancer cell viability and clonal formation,induced cell apoptosis and cycle arrest in G1/S phase,decreased MMP and increased ROS levels.There was no toxic effect on normal endothelial cells.Conclusion The petroleum ether extract of Sageretia thea may induce apoptosis by increasing ROS to cause MMP collapse,followed by activating mitochondrial pathway,thereby hindering the growth of breast cancer cells.These results could support the application of Sageretia thea to anti-breast tumor in the folk.
10.Highlights and cutting-edge advances from the 2024 Korean International Gastric Cancer Week(KINGCA WEEK 2024)
Longfei GOU ; Hao CHEN ; Yanfeng HU ; Jiang YU ; Haijun DENG
Chinese Journal of General Surgery 2024;33(10):1705-1713
From September 26 to 28,2024,the 11th Korean International Gastric Cancer Week(KINGCA WEEK 2024),a prestigious academic conference in the field of gastric cancer,was held in Seoul.Organized by the Korean Gastric Cancer Association,the conference featured one main venue,18 sub-venues,and 16 thematic symposiums,including 100 invited presentations and four keynote speeches,attracting 788 experts and scholars from around the world.Additionally,the conference set 16 themes and received 425 submissions from 24 countries,including Republic of Korea,China,Japan,and the United States.After a review process,365 submissions were accepted,which included eight plenary oral presentations,78 oral reports,and 279 poster presentations.The conference covered many hot topics in gastric cancer diagnosis and treatment,with a particular focus on surgical-related areas such as treatment strategies for metastatic gastric cancer,an international consensus meeting on the conversion therapy for stage Ⅳgastric cancer,future research directions of the Korean Laparoendoscopic Gastrointestinal Surgery Study Group,the development of new surgical instruments and equipment,and key issues in lymph node dissection,resection,and reconstruction during minimally invasive gastric cancer surgeries.Furthermore,our team was invited to present two oral reports on"the application of artificial intelligence in minimally invasive gastric cancer surgery".This report aims to detail the dynamics and hotspots related to surgical treatment for gastric cancer,providing valuable references and insights for domestic surgical peers.

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