Endoscopic spine surgery (ESS) has traditionally been employed for lumbar disc herniation (LDH). Recent innovations in surgical methods and technologies have expanded its range to address other spinal pathologies, providing minimally invasive solutions with potential clinical benefits. Our review aims to summarize the applications, clinical outcomes, and limitations of ESS beyond LDH, focusing on its role in complex spinal conditions such as stenosis, thoracic disc herniation, spinal tumors, synovial cysts, and failed back surgery syndrome. A thorough review of the literature was conducted to assess and summarize the current evidence regarding ESS applications for spinal conditions beyond LDH surgery. Areas of focus included innovations in technology and technique, as well as comparisons with conventional open surgical methods. ESS shows notable potential across different spinal conditions by providing minimally invasive alternatives to traditional open surgery. Its use could be associated with reduced surgical morbidity, shorter recovery times, and improved patient outcomes. In particular, ESS is versatile in addressing both degenerative and neoplastic conditions of the spine. Despite this, challenges such as technical complexity, steep learning curves, and limited indications for certain pathologies remain as barriers to wider adoption. ESS is evolving in spine surgery, extending its utility beyond LDH surgery. While the current evidence largely supports its clinical efficacy, further studies are needed to address the present limitations and optimize its application. Future developments in surgical training and technology will likely enhance its adoption and broaden its clinical indications.
Breast augmentation has evolved significantly since its inception in the 1960s, with polyurethane (PU)-coated breast implants emerging as a notable innovation in the 1970s. Despite their potential advantages in reducing capsular contracture, concerns persist among surgeons regarding their safety and technical challenges, particularly in primary augmentation mammoplasty. The aim of this study was to highlight the numerous advantages and safety of PU implants, promoting them as a viable option for primary augmentation mammoplasty. The authors experience documented in the form of a case series was combined with a systematic review that examined the safety and efficacy of PU-coated breast implants for primary augmentation mammoplasty. A case series involving 50 patients who underwent this procedure from January 2023 to January 2024 is reported. Additionally, a comprehensive literature review from 2000 to 2023, using the PubMed, CINAHL, EMBASE, and Scopus databases, along with clinical experience and case reports were conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines. Studies indicate a low risk of malignancy associated with PU-coated implants, with no evidence of free 2,4-toluenediamine in the serum samples. A nearly nonexistent occurrence of capsular contracture, along with minimal surgical complexities make it an excellent choice for achieving functional and aesthetic results. PU-coated breast implants demonstrate equivalence to standard textured implants for primary augmentation mammoplasty, with advantages including reduced capsular contracture rates and improved stability. Despite historical skepticism, evidence supports their safety and effectiveness, positioning them as a viable option in breast augmentation surgery. Implementation of appropriate surgical techniques is paramount to optimizing outcomes and ensuring patient satisfaction.
Augmented reality (AR) is an emerging technology in spine surgery with the potential to enhance intraoperative visualization and precision by overlaying virtual images on anatomical structures. This bibliometric review analyzes trends in research and publication growth related to AR in spinal neurosurgery between 2013 and 2024. A search across PubMed identified 267 articles. After screening, we analyzed 98 relevant studies, revealing exponential growth in AR research, with publications increasing from 1 in 2013 to 28 in 2024. The focus of research evolved over the years, with instrumentation being the dominant topic in 2020, and a broader emphasis on multi-domain AR applications in 2024. The United States led in publication output, followed by Germany, Sweden, and Switzerland. The increasing number of studies reflects AR's growing adoption in both specialized and broad spine surgery applications. Although AR has demonstrated its potential to improve surgical precision and education, further research is needed to assess long-term clinical outcomes and overcome barriers to widespread implementation.
27 June 2025 in Aesthetic Surgery Journal Open Forum
Background: Hematoma is the most common early complication following facelift surgery, leading to increased morbidity and suboptimal aesthetic outcomes. Hemostatic nets, adapted from abdominoplasty techniques, aim to reduce hematoma formation by eliminating dead space and stabilizing tissue planes. Objectives: To evaluate the effectiveness and safety of hemostatic nets in facelift (rhytidectomy) procedures and determine their impact on postoperative complications, particularly hematoma formation. Methods: A systematic review and meta-analysis were performed in accordance with PRISMA guidelines and registered on PROSPERO (CRD420251027741). A comprehensive search of PubMed, Embase, and Scopus was conducted through April 2025 to identify studies evaluating the use of hemostatic nets in facelift procedures. Eligible studies included adult patients undergoing rhytidectomy, comparing outcomes with and without hemostatic net use. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for key complications. Results: Seven studies involving 1,919 patients were included. Meta-analysis of five studies revealed a significant reduction in hematoma risk in the hemostatic net group (OR: 0.085; 95% CI: 0.01–0.57; p=0.0113). There were no statistically significant differences in skin necrosis (OR: 0.29; p=0.1057) or transient ischemia/edema (OR: 0.70; p=0.1855). Seroma and infection rates were low and comparable between groups. Conclusions: Hemostatic nets significantly reduce hematoma incidence without increasing other postoperative complications. Their integration in facelift procedures represents a safe and effective adjunct, warranting further investigation through prospective, high-quality trials.