BACKGROUND

Corticosteroids have been used in ophthalmology for its potent anti-inflammatory and immunosuppressive actions. Although the role of corticosteroid treatment is pivotal in the treatment of numerous inflammatory diseases and as postoperative management of patients who undergo ocular surgeries, intraocular pressure (IOP) elevation has been a significant ocular side effect that could result after steroid use. Evaluating the changes in IOP in pediatric eyes will provide early detection and timely intervention to prevent glaucomatous optic neuropathy.

OBJECTIVE

This study aimed to determine the incidence of IOP elevation among pediatric patients given corticosteroids after strabismus surgery in a tertiary hospital in Manila, Philippines.

METHODS

This is a single-center, retrospective, observational study that employs review of the clinical records of pediatric patients who underwent strabismus surgery between January 2015 and December 2022. This study was conducted last February to November 2023. Data were gathered and descriptively summarized regarding patient demographics, ophthalmologic diagnosis, type of strabismus surgery performed, preoperative and postoperative IOP readings, frequency and duration of postoperative topical steroid use, and treatment received and response to elevated IOP.

RESULTS

Forty-five (28.48%) out of the 158 pediatric patients who had strabismus surgery during the study period met the inclusion criteria for the study. The mean age of pediatric patients was 11.38 ± 5.28 years (range 2-18 years old). There were more males (55.6%) than females. All patients were administered Tobramycin + Dexamethasone eyedrops, ointment or both. The baseline, peak, and net change in IOP were 13.5 ± 2.7 mmHg, 23.1 ± 8.8 mmHg and 10 ± 8.4 mmHg respectively. IOP increased in thirty-seven (82.2%) of the patients from baseline, and 21 (56.7%) of them had a considerable rise. For most patients with considerable rise of IOP, topical steroid medication was either stopped or immediately tapered off. Nine patients received topical IOP-lowering medicine, and most of them returned to normal IOP levels two months following surgery. After then, topical IOP-lowering drugs were stopped.

CONCLUSION

IOP elevation following strabismus surgery was frequently associated with topical steroid usage, and most patients experienced considerable IOP elevation. It is highly advised to closely monitor IOP following strabismus surgery, particularly in children receiving topical steroid treatment.

Human ; Male ; Female ; Child Preschool: 2-5 Yrs Old ; Child: 6-12 Yrs Old ; Adolescent: 13-18 Yrs Old ; Strabismus ; Intraocular Pressure ; Ophthalmology ; World Health Organization ; Optic Nerve Diseases ; Volition ; General Surgery

Vision, Ocular ; Ophthalmology

Genetic Counseling ; Ophthalmology ; Philippines

BACKGROUND : Artificial intelligence (AI) offers innovative and efficient training methods for neurosurgery residents, yet existing evidence remains fragmented, often limited to specific technological applications and failing to fully assess their impact on clinical competence. Therefore, this study aimed to map the current evidence on AI applications in neurosurgery and curriculum development. METHODS : This study was conducted following the preferred reporting items for systematic reviews and meta-analyses guidelines by searching for observational or experimental studies on AI in neurosurgery residency education (2020–2025) in PubMed, ScienceDirect, and Google Scholar. Keywords included variations of “training,” “artificial intelligence,” and “neurosurgery”. After screening 719 initial records and assessing their eligibility, 10 studies were selected for narrative synthesis. RESULTS : A review of 10 studies reveals 2 key roles for AI in neurosurgical training: improving psychomotor skills through machine learning-integrated simulators and reinforcing theoretical knowledge through large language models (LLMs). Virtual reality (VR) simulators such as NeuroVR and virtual operative assistant provide objective metrics and personalized feedback, with assessment accuracy of up to 80%. LLMs such as ChatGPT show 50.4–84.8% accuracy in answering exam questions. However, simulators cannot yet capture all surgical competencies, and LLMs are still weak in processing image-based data. CONCLUSIONS AI can improve neurosurgical training through personalized, objective learning tools, but AI simulators and LLMs remain supplements and cannot replace human expertise in clinical reasoning and complex image interpretation.
artificial intelligence ; education ; internship and residency ; medicine ; neurosurgery ; simulation training

BACKGROUND

Anterior cruciate ligament (ACL) reconstruction is a crucial procedure for restoring knee stability and functionality, especially in active individuals. While various surgical techniques and graft options are available, preferences among surgeons vary based on regional factors, patient demographics and institutional resources. This study aimed to explore the current practices and preferences of Filipino orthopedic surgeons in ACL reconstruction.

METHODS

A cross-sectional survey was conducted among fellowship-trained Filipino orthopedic surgeons. Data were collected via structured questionnaires focusing on demographics, preoperative protocols, surgical techniques, graft selection and postoperative practices. Descriptive statistics and bivariate analysis were used to summarize and identify trends.

RESULTS

A total of 68 surgeons participated in the study. The majority (91.2%) preferred hamstring tendon grafts and single-bundle reconstruction techniques. Most respondents opted for anteromedial portal femoral tunnel creation and button fixation for the femoral tunnel, while interference screws were commonly used for tibial tunnel fixation. Immediate weight-bearing post-surgery was allowed by 94.1% of respondents, with varying timelines for returning to sports activities. Younger surgeons were more likely to adopt augmentation techniques and clear patients for earlier return to activity.

CONCLUSION

The study highlights prevailing trends in ACL reconstruction practices among Filipino orthopedic surgeons, emphasizing the preference for hamstring grafts and single-bundle techniques. Regional limitations, such as the unavailability of allografts, significantly influence these choices. These findings underscore the need for localized guidelines and further research to standardize care and optimize patient outcomes.

Human ; Anterior Cruciate Ligament ; Orthopedic Surgeons ; General Surgery ; Transplants

BACKGROUND

The Division of Colorectal Surgery at the Philippine General Hospital (PGH) conducts hundreds of surgeries annually for benign and malignant colorectal conditions. Since 2019, the Division has implemented an Enhanced Recovery After Surgery (ERAS) program to improve patient outcomes. However, its impact on hospital costs—critical for a government hospital—has not yet been studied.

OBJECTIVE

This study aimed to evaluate the effect of ERAS on healthcare costs for elective colorectal surgeries performed at PGH in 2021.

METHODS

A retrospective observational study was conducted on adult patients who underwent elective colorectal surgeries under the ERAS protocol in 2021. Medical and billing records were retrieved using the hospital’s electronic medical records (EMR) system, excluding cases with incomplete data. Procedures were categorized by type [stoma closure, colonic or rectal resection, reversal of Hartmann’s, or cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)] and surgical approach (open, laparoscopic, or robotic). Costs were classified into diagnostics, facility fees, medications, surgery, and hospital supplies. ERAS compliance rates were extracted from the online ERAS Interactive Audit System (EIAS), and linear regression analysis was performed.

RESULTS

Among 114 elective colorectal surgeries, records for 90 cases were analyzed. Surgery-related expenses accounted for the highest mean hospital costs across all procedure types. An inverse correlation between ERAS compliance and total cost was observed for open surgeries, with statistically significant reductions in stoma closures and open colon resections (p-value: 0.0213 and 0.0134, respectively). However, minimally invasive surgeries (MIS) did not demonstrate cost reductions with increasing ERAS compliance, likely due to additional expenses associated with advanced equipment. Linear regression indicated that higher compliance rates generally led to decreased hospital costs.

CONCLUSION

Standardized care through ERAS has been associated with cost savings compared to traditional perioperative management. This study supports the conclusion that higher ERAS compliance can reduce hospital costs in open colorectal surgeries. However, the higher costs of MIS procedures, driven by equipmentrelated expenses, may offset potential savings from ERAS adherence. Further research is warranted to explore the cost implications of ERAS in MIS cases.

Costs And Cost Analysis ; Colorectal Surgery

The clinical burden of colorectal cancer (CRC) is high. Population-based screening and early detection are essential to improve the long-term clinical outcome. Nonetheless, a significant proportion of patients still present at an advanced stage, including with acute large bowel obstruction. Image-enhanced endoscopy and artificial intelligence can improve the detection and diagnosis of colonic adenomas and early cancer. Endoscopic resection is regarded as the preferred curative treatment option for colonic adenoma and T0 and T1 CRC limited to the superficial submucosa. Emergency colonic stenting as bridge to interval curative surgery is increasingly accepted as a first-line option when technically feasible. Minimally invasive resection techniques such as laparoscopic colectomy and robot-assisted colorectal surgery have also come of age. These techniques reduce post-treatment morbidity, shorten the recovery process and can be cost-effective while maintaining long-term oncological cure. These outcome measures are relevant to our patients; therefore, minimally invasive approaches to curative resection should be embraced.
Humans ; Colorectal Neoplasms/surgery* ; Minimally Invasive Surgical Procedures/methods* ; Laparoscopy/methods* ; Colectomy/methods* ; Robotic Surgical Procedures/methods* ; Treatment Outcome ; Colonoscopy/methods*

The unilateral cleft lip repair surgery has undergone over a century of development, marked by achievements and difficulties. Although the development of the methods for cleft lip repair has passed the period of rapid advancement, there remains an urgent need in clinical practice to further improve these methods in order to enhance clinical outcomes. This article aims to improve cleft lip repair methods by analyzing and elaborating on various aspects, including the attributes of cleft lip repair, the shift in concepts of cleft lip repair, innovations in surgical techniques, technical improvements, and classifications and repair methods for correcting secondary deformities. The analysis is based on the author's research and experience.
Cleft Lip/surgery* ; Humans ; Plastic Surgery Procedures/methods* ; Surgical Flaps

OBJECTIVES

o demonstrate the utility of the supraclavicular artery island flap (SCAIF) as a viable alternative to free tissue transfer for reconstruction of large cervicofacial defects.

METHODS

Design:Case Report

Setting:Tertiary National University Hospital

Patient: One

RESULTS

A 43-year-old woman with a giant cavernous hemangioma measuring 21.43 x 9.91 x 20.75cm underwent tumor resection and immediate reconstruction using SCAIF. Following preoperative embolization and complete tumor excision, an 11 x 15cm cervicofacial defect was successfully reconstructed using SCAIF. The patient experienced post-operative complications including multiple wound dehiscences and hypertrophic scar formation but achieved significant functional and aesthetic improvement. At three months follow up, the patient reported cessation of bleeding episodes, improved feeding capacity, and enhanced quality of life despite persistent tracheostomy dependence. Plans for secondary surgery include scar revision, commissuroplasty, and intralesional steroid injections.

CONCLUSION

The supraclavicular artery island flap presents a practical, cost-effective alternative to free tissue transfer for extensive cervicofacial reconstruction, particularly in resource-limited environments or in patients where free tissue transfer is contraindicated. Advantages include good color match, wide arc of rotation, and ease of harvest. Despite potential complications, it offers excellent functional and aesthetic outcomes with acceptable donor site morbidity.

Human ; Female ; Young Adult: 19-24 Yrs Old ; Aids-related Complex ; Neoplasms ; Costs And Cost Analysis ; General Surgery ; Environment ; Research Report ; Steroids ; Tracheostomy ; Hospitals

INTRODUCTION AND OBJECTIVE

The increasing demand for cost-effective surgical techniques has driven innovations in robotic-assisted radical prostatectomy (RARP). While single-port robotic surgery reduces invasiveness and improves cosmesis, its widespread use is limited by high costs and technical constraints. This study evaluates the safety, feasibility and cost-effectiveness of extraperitoneal single-port robotic-assisted radical prostatectomy (espRARP) using a modified Da Vinci Si HD system, employing a wound protector and surgical glove as a low-cost multi-channel laparoscopic port.

METHODS

Ten patients with localized prostate cancer underwent espRARP using a three-arm Da Vinci Si system and side docking to enhance instrument access. A homemade multi-channel port was constructed using an Alexis® wound protector and surgical gloves. Perioperative outcomes—including operative time, blood loss, complications and oncologic results were analyzed descriptively.

RESULTS

All cases were completed without conversion to open surgery. The mean operative time was 215.8 minutes with an estimated blood loss of 200 mL. No positive surgical margins were recorded, and 20% of patients exhibited pathological upgrading. The average hospital stay was 3.4 days. One patient developed a Clavien–Dindo II complication; no major complications occurred

LIMITATIONS

This pilot study is limited by its small sample size (n = 10), single-surgeon, single institution design, short follow-up period, and absence of functional outcome assessment. Only descriptive analysis was performed without statistical comparison.

CONCLUSION

The modified espRARP technique using a low-cost glove-port and three-arm Da Vinci Si system is safe, feasible and cost-efficient. Comparable perioperative and oncologic outcomes to conventional multi-port and proprietary single-port systems were achieved at a fraction of the cost. This approach provides a practical and accessible alternative for robotic prostatectomy in resource-limited healthcare settings.

Human ; Prostatectomy ; General Surgery ; Prostatic Neoplasms