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  1. Article: Disruptive technology will transform what we think of as robotic surgery in under ten years.

    Dunning, Joel

    Annals of cardiothoracic surgery

    2019  Volume 8, Issue 2, Page(s) 274–278

    Abstract: What is currently described as 'robotic surgery' will undergo a transformation as rapid as the transformation from Kodak film cameras to digital cameras, from Nokia phones to iPhones, from listening to music on tape to CD then to digital downloading, and ...

    Abstract What is currently described as 'robotic surgery' will undergo a transformation as rapid as the transformation from Kodak film cameras to digital cameras, from Nokia phones to iPhones, from listening to music on tape to CD then to digital downloading, and the transformation that is shortly to come from petrol cars into electric cars. We are only at the very infancy of what is currently termed robotic surgery, but in reality, is in fact just computer-assisted, instrument-controlled surgery. This article will describe the current state of robotic surgery and will then go on to look at why we will hardly recognize the surgical world in ten years' time, as novel, disruptive technology transforms our specialty.
    Keywords covid19
    Language English
    Publishing date 2019-04-06
    Publishing country China
    Document type Editorial
    ZDB-ID 2713627-9
    ISSN 2304-1021 ; 2225-319X
    ISSN (online) 2304-1021
    ISSN 2225-319X
    DOI 10.21037/acs.2019.03.02
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Is vacuum-assisted closure therapy the main culprit in right ventricular rupture after deep sternal wound infection?

    Abbas, Ahmed A M / McPherson, Iain / Dunning, Joel

    Journal of wound care

    2023  Volume 32, Issue 8, Page(s) 520–526

    Abstract: Right ventricular rupture after deep sternal wound infection (DSWI) is a rare but fatal complication, and can occur with or without vacuum assisted closure (VAC) therapy. There is currently no strong evidence to suggest whether or not VAC therapy is a ... ...

    Abstract Right ventricular rupture after deep sternal wound infection (DSWI) is a rare but fatal complication, and can occur with or without vacuum assisted closure (VAC) therapy. There is currently no strong evidence to suggest whether or not VAC therapy is a contributing factor to this complication. In total, 30 articles were retrieved and assessed through a systematic review strategy from 1953 to 2022. The keywords: 'vacuum assisted closure'; 'VAC'; 'negative pressure wound therapy'; 'deep sternal wound infection'; 'DSWI'; 'right ventricular rupture'; and 'cardiac rupture' were used in the search. Overall, 15 of the included articles satisfied the predefined eligibility criteria. Fatal right ventricular ruptures were reported in 18 (36%) out of 50 cases. In this article, the risk factors, mechanisms and management of right ventricular rupture are discussed. A novel view of the mechanism of VAC-associated right ventricular rupture is highlighted, with a focus on both pre- and intraoperative management.
    Language English
    Publishing date 2023-08-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 1353951-6
    ISSN 0969-0700
    ISSN 0969-0700
    DOI 10.12968/jowc.2023.32.8.520
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Pioneers, sceptics and those who seek the truth.

    Dunning, Joel

    Journal of thoracic disease

    2016  Volume 8, Issue 9, Page(s) E1017–E1018

    Language English
    Publishing date 2016-07-04
    Publishing country China
    Document type Journal Article ; Comment
    ZDB-ID 2573571-8
    ISSN 2077-6624 ; 2072-1439
    ISSN (online) 2077-6624
    ISSN 2072-1439
    DOI 10.21037/jtd.2016.08.10
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  4. Article ; Online: A view of the Pulmonary Metastasectomy in Colorectal Cancer (PulMiCC) trial from the coalface.

    Dunning, Joel

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

    2016  Volume 50, Issue 5, Page(s) 798–799

    MeSH term(s) Colorectal Neoplasms/surgery ; Humans ; Lung Neoplasms/surgery ; Metastasectomy ; Pneumonectomy
    Language English
    Publishing date 2016
    Publishing country Germany
    Document type Editorial ; Comment
    ZDB-ID 639293-3
    ISSN 1873-734X ; 1010-7940 ; 1567-4258
    ISSN (online) 1873-734X
    ISSN 1010-7940 ; 1567-4258
    DOI 10.1093/ejcts/ezw156
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  5. Article ; Online: Safe implementation of surgical innovation: a prospective registry of the Versius Robotic Surgical System.

    Soumpasis, Ilias / Nashef, Samer / Dunning, Joel / Moran, Paul / Slack, Mark

    BMJ surgery, interventions, & health technologies

    2023  Volume 5, Issue 1, Page(s) e000144

    Abstract: Objectives: To describe a new, international, prospective surgical registry developed to accompany the clinical implementation of the Versius Robotic Surgical System by accumulating real-world evidence of its safety and effectiveness.: Interventions: ...

    Abstract Objectives: To describe a new, international, prospective surgical registry developed to accompany the clinical implementation of the Versius Robotic Surgical System by accumulating real-world evidence of its safety and effectiveness.
    Interventions: This robotic surgical system was introduced in 2019 for its first live-human case. With its introduction, cumulative database enrollment was initiated across several surgical specialties, with systematic data collection via a secure online platform.
    Main outcome measures: Pre-operative data include diagnosis, planned procedure(s), characteristics (age, sex, body mass index and disease status) and surgical history. Peri-operative data include operative time, intra-operative blood loss and use of blood transfusion products, intra-operative complications, conversion to an alternative technique, return to the operating room prior to discharge and length of hospital stay. Complications and mortality within 90 days of surgery are also recorded.
    Results: The data collected in the registry are analyzed as comparative performance metrics, by meta-analyses or by individual surgeon performance using control method analysis. Continual monitoring of key performance indicators, using various types of analyses and outputs within the registry, have provided meaningful insights that help institutions, teams and individual surgeons to perform most effectively and ensure optimal patient safety.
    Conclusions: Harnessing the power of large-scale, real-world registry data for routine surveillance of device performance in live-human surgery from first use will enhance the safety and efficacy outcomes of innovative surgical techniques. Data are crucial to driving the evolution of robot-assisted minimal access surgery while minimizing risk to patients.
    Trial registration number: CTRI/2019/02/017872.
    Language English
    Publishing date 2023-02-27
    Publishing country England
    Document type Journal Article
    ISSN 2631-4940
    ISSN (online) 2631-4940
    DOI 10.1136/bmjsit-2022-000144
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  6. Article ; Online: Safe Implementation of a Next-Generation Surgical Robot: First Analysis of 2,083 Cases in the Versius Surgical Registry.

    Soumpasis, Ilias / Nashef, Samer / Dunning, Joel / Moran, Paul / Slack, Mark

    Annals of surgery

    2023  Volume 278, Issue 4, Page(s) e903–e910

    Abstract: Objective: To present the first report of data from the Versius Surgical Registry, a prospective, multicenter data registry with ongoing collection across numerous surgical indications, developed to accompany the Versius Robotic Surgical System into ... ...

    Abstract Objective: To present the first report of data from the Versius Surgical Registry, a prospective, multicenter data registry with ongoing collection across numerous surgical indications, developed to accompany the Versius Robotic Surgical System into clinical practice.
    Background: A data registry can be utilized to minimize risk to patients by establishing the safety and effectiveness of innovative medical devices and generating a thorough evidence base of real-world data.
    Methods: Surgical outcome data were collected and inputted through a secure online platform. Preoperative data included patient age, sex, body mass index, surgical history, and planned procedures. Intraoperative data included operative time, complications during surgery, conversion from robot-assisted surgery to an alternative surgical technique, and blood loss. Postoperative outcome data included length of hospital stay, complications following surgery, serious adverse events, return to the operating room, readmission to the hospital, and mortality within 90 days of surgery.
    Results: This registry analysis included 2083 cases spanning general, colorectal, hernia, gynecologic, urological, and thoracic indications. A considerable number of cases were recorded for cholecystectomy (n=539), anterior resection (n=162), and total laparoscopic hysterocolpectomy (n=324) procedures. The rates of conversion to an alternative technique, serious adverse events, and 90-day mortality were low for all procedures across all surgical indications.
    Conclusions: We report the large-scale analysis of the first 2083 cases recorded in this surgical registry, with substantial data collected for cholecystectomies, anterior resections, and total laparoscopic hysterectomies. The extensive surgical outcome data reported here provide real-world evidence for the safe implementation of the surgical robot into clinical practice.
    MeSH term(s) Humans ; Female ; Prospective Studies ; Robotics ; Hysterectomy ; Laparoscopy/methods ; Robotic Surgical Procedures/methods ; Registries
    Language English
    Publishing date 2023-04-10
    Publishing country United States
    Document type Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 340-2
    ISSN 1528-1140 ; 0003-4932
    ISSN (online) 1528-1140
    ISSN 0003-4932
    DOI 10.1097/SLA.0000000000005871
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  7. Article: Video-assisted thoracoscopic microthymectomy.

    Dunning, Joel

    Annals of cardiothoracic surgery

    2015  Volume 4, Issue 6, Page(s) 550–555

    Abstract: There are many techniques for performing video-assisted thoracoscopic (VATS) thymectomy. This article describes one particular technique that we employ in thymectomies as well as lobectomies. The principles of both operations are as follows, and have ... ...

    Abstract There are many techniques for performing video-assisted thoracoscopic (VATS) thymectomy. This article describes one particular technique that we employ in thymectomies as well as lobectomies. The principles of both operations are as follows, and have been presented in greater detail for lobectomies previously: (I) the use of ports no greater than 5-mm in the intercostal spaces; (II) the use of a 12-mm subxiphoid port; (III) subxiphoid removal of the specimen; (IV) carbon dioxide (CO2) insufflation; (V) vision enabled through a 5-mm camera; (VI) in microlobectomies, the use of a 5-mm stapling device. These principles are particularly suited to thymectomy, as there are no large vascular structures that require stapling and a large number of the instruments required for thymectomy are already 5-mm in diameter, including energy devices, graspers, clip applicators and suction devices. We believe that this technique, which eliminates the need for large incisions in the intercostal spaces, is less painful than other techniques that we have employed, including intercostal uniportal surgery. It also allows the use of CO2 insufflation, which is very useful indeed in endoscopic thymectomies. Furthermore, microthymectomy is technically easier than subxiphoid-only techniques, in that it requires little modification compared to a more conventional VATS thymectomy. We describe this technique in detail in this article.
    Keywords covid19
    Language English
    Publishing date 2015-12-04
    Publishing country China
    Document type Journal Article ; Review
    ZDB-ID 2713627-9
    ISSN 2304-1021 ; 2225-319X
    ISSN (online) 2304-1021
    ISSN 2225-319X
    DOI 10.3978/j.issn.2225-319X.2015.11.04
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  8. Article ; Online: Thoracoscopic diaphragm plication.

    Dunning, Joel

    Interactive cardiovascular and thoracic surgery

    2015  Volume 20, Issue 5, Page(s) 689–690

    Abstract: Diaphragm plication is a relatively common operation in thoracic surgery and can be a major benefit to patients who have suffered phrenic nerve injury and who are left short of breath as a result [1]. With the advent of video-assisted thoracoscopic ... ...

    Abstract Diaphragm plication is a relatively common operation in thoracic surgery and can be a major benefit to patients who have suffered phrenic nerve injury and who are left short of breath as a result [1]. With the advent of video-assisted thoracoscopic surgery (VATS) many surgeons have attempted diaphragm plication endoscopically. Barriers to implementation of VATS diaphragm plication include concerns regarding initial port entry with such a high diaphragm, the technical ability to suture by VATS and concern regarding the placement of sutures to a thin diaphragm draped tightly over a spleen, liver or large intestine. We present a simple way to overcome these barriers using carbon dioxide to increase the size of the hemithorax and relax the tension on the diaphragm, an Endostitch device that makes pledgeted suturing straightforward and a novel endograsper that allows a wide range of angles to be achieved when handling the diaphragm.
    MeSH term(s) Carbon Dioxide/administration & dosage ; Carbon Dioxide/pharmacology ; Diaphragm/innervation ; Diaphragm/surgery ; Humans ; Minimally Invasive Surgical Procedures/methods ; Patient Safety ; Peripheral Nerve Injuries/surgery ; Phrenic Nerve/injuries ; Pneumothorax, Artificial/methods ; Respiratory Paralysis/physiopathology ; Respiratory Paralysis/surgery ; Thoracic Surgery, Video-Assisted/instrumentation ; Thoracic Surgery, Video-Assisted/methods ; Treatment Outcome
    Chemical Substances Carbon Dioxide (142M471B3J)
    Language English
    Publishing date 2015-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2095298-3
    ISSN 1569-9285 ; 1569-9293
    ISSN (online) 1569-9285
    ISSN 1569-9293
    DOI 10.1093/icvts/ivv018
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  9. Article ; Online: Results of the PARAMEDIC-2 trial and how they relate to resuscitation after cardiac surgery.

    Dunning, Joel / Trevis, Jason

    The Journal of thoracic and cardiovascular surgery

    2020  Volume 160, Issue 6, Page(s) 1519–1522

    MeSH term(s) Cardiac Surgical Procedures/adverse effects ; Cardiopulmonary Resuscitation/methods ; Emergency Medical Services ; Humans ; Out-of-Hospital Cardiac Arrest/etiology ; Out-of-Hospital Cardiac Arrest/therapy ; Randomized Controlled Trials as Topic ; Survival Rate/trends ; United Kingdom/epidemiology
    Language English
    Publishing date 2020-03-30
    Publishing country United States
    Document type Editorial
    ZDB-ID 3104-5
    ISSN 1097-685X ; 0022-5223
    ISSN (online) 1097-685X
    ISSN 0022-5223
    DOI 10.1016/j.jtcvs.2020.02.050
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  10. Article ; Online: Pulmonary nodules precision localization techniques.

    Nardini, Marco / Dunning, Joel

    Future oncology (London, England)

    2020  Volume 16, Issue 16s, Page(s) 15–19

    Abstract: The advent of helical high-resolution CT scanners, the application of screening programs and the follow-up of patient with oncological history, led to an increasing number of diagnosis of small pulmonary nodule (less than 10 mm in maximum diameter), ... ...

    Abstract The advent of helical high-resolution CT scanners, the application of screening programs and the follow-up of patient with oncological history, led to an increasing number of diagnosis of small pulmonary nodule (less than 10 mm in maximum diameter), partially solid nodule or completely ground glass ones. Their management is controversial. Excisional biopsy by mean of video-assisted thoracic surgery is often a viable choice but to locate these lesions intraoperatively can be impossible without the aid of preoperative or intraoperative localization techniques. In this brief review we will analyze the benefit of adopting localization techniques prior to pulmonary resection for small pulmonary lesions and face the advantages and problems with the main techniques described in the literatures.
    MeSH term(s) Biopsy/methods ; Bronchoscopy/methods ; Humans ; Image-Guided Biopsy/methods ; Intraoperative Care/methods ; Lung/diagnostic imaging ; Lung/pathology ; Lung/surgery ; Lung Neoplasms/diagnosis ; Lung Neoplasms/pathology ; Lung Neoplasms/surgery ; Preoperative Care/methods ; Solitary Pulmonary Nodule/diagnosis ; Solitary Pulmonary Nodule/pathology ; Solitary Pulmonary Nodule/surgery ; Thoracic Surgery, Video-Assisted/methods ; Tomography, X-Ray Computed
    Language English
    Publishing date 2020-05-21
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2274956-1
    ISSN 1744-8301 ; 1479-6694
    ISSN (online) 1744-8301
    ISSN 1479-6694
    DOI 10.2217/fon-2019-0069
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