Publikationen

Shortcoming of the Mouse Model of Postoperative Ileus

2026-01-12T13:47:07Z

Shortcoming of the Mouse Model of Postoperative Ileus von Stumberg, Maximiliane; Akinci, Ejder; Ertim, Berkan; Oetzmann von Sochaczewski, Christina Background/Objectives: The mouse model of postoperative ileus separates the gastrointestinal tract into 15 sections, 10 of which are in the small intestine, to measure intestinal transit time. Usually, mice are standardised according to age or body weight. This inherently assumes that intestinal lengths are similar among the included mice irrespective of the method of standardisation. We aimed to test this assumption by comparing intestinal lengths, measuring their variability in commonly used out- and inbred strains. Methods: Mice were humanely killed, and their intestines were removed and measured in a standardised fashion. We compared the coefficients of variability via the modified signed-rank likelihood test. Results: We included 125 mice of the Crl:CD1(ICR) background and 10 mice of the C57Bl/6J and C57Bl/6NCrl substrains. The mean small intestinal length of Crl:CD1(ICR) mice was 437 mm (standard deviation 54), while it was 473 mm (standard deviation 29) in C57Bl/6J mice and 419 mm (standard deviation 57) in C57Bl/6NCrl mice. The respective coefficients of variation were 12.4%, 6.1%, and 13.6% and did not differ between the out- and inbred strains (modified signed likelihood ratio 5.878, p = 0.053). This was not the case for caecal and large intestinal lengths. Conclusions: Due to substantial variation in small intestinal length, the separation of the small intestine into ten equally sized segments to measure intestinal transit time might not be warranted. This could be addressed by measuring small intestinal transit time in absolute values and relative to the intestinal length.

AI-Enhanced 3D Models in Global Virtual Reality Case Conferences for Surgical Care in a Low-Income Country

2025-11-05T17:46:45Z

AI-Enhanced 3D Models in Global Virtual Reality Case Conferences for Surgical Care in a Low-Income Country Obst, Miriam; Arensmeyer, Jan; Bonsmann, Henrik; Kolbinger, Andreas; Kigenyi, Joel; Oneka, Francis; Owere, Benard; Schmidt, Joachim; Feodorovici, Philipp; Wynands, Jan Background: Approximately 5 billion people worldwide lack adequate access to surgical care, primarily in the Global South. Especially in crisis regions and war zones, telemedical applications may enhance health services. This study explores the feasibility of using artificial intelligence (AI)-enhanced 3D imaging and extended reality (XR) technologies for intercontinental surgical case conferences in a low-resource scenario in Uganda. Our pilot study aims to assess the value of these technologies to address the lack of surgical resources and multilateral knowledge exchange.
Objective: This study intends to determine the feasibility of using new AI-enhanced image modeling technology within an immersive spatial XR scenario to collaboratively and remotely assess reconstructive patient cases in the resource-limited country of Uganda.
Methods: Within a surgical camp at Lamu Medical Centre, Uganda, 3D models of patients’ conditions were created using a smartphone app. Digital models were generated from photographs taken on-site and processed into 3D formats to be visualized in virtual case conferences. Here, surgeons from Uganda and Germany used virtual reality (VR) headsets to collaboratively discuss case strategies while marking surgical approaches on each digital patient model.
Results: The study included 15 patients requiring reconstructive surgery, with a diverse range of conditions. The use of XR technology facilitated detailed visualization and discussion of surgical strategies. The process was time-efficient, with a total of under 8 minutes per case for data acquisition and model creation, and resource-efficient with surgeons reporting sufficient quality of smartphone-derived models. Valuable user experience and precise interaction during the VR case processing were found, underlining its potential to improve surgical planning and patient care in resource-limited settings.
Conclusions: The findings indicate that AI-enhanced 3D imaging and immersive virtual communication platforms are valuable tools for integrative surgical case assessments. The cost-effectiveness of the used consumer solutions should be especially beneficial for low-resource environments. While the study demonstrates the feasibility of this approach, further research is needed to explore a broader application and impact of these technologies in global health. The study highlights the potential of XR to enhance training and surgical precision, contributing to better health care outcomes in underserved regions.

IDEAL–compliant implementation of the Dexter^® surgical robot in cholecystectomy

2025-08-12T11:31:25Z

IDEAL–compliant implementation of the Dexter^® surgical robot in cholecystectomy Dohmen, Jonas; Weber, Julia; Arensmeyer, Jan; Feodorovici, Philipp; Henn, Jonas; Schmidt, Joachim; Kalff, Jörg C.; Matthaei, Hanno Objectives: The integration of advanced technologies is transforming surgical practice, particularly through robotic systems. This study presents the early clinical implementation of the Dexter^® surgical robot for cholecystectomy and evaluates clinical outcomes using the IDEAL framework.
Methods: Twenty patients underwent elective robotic-assisted cholecystectomy using the Dexter^® robot. A thorough implementation process, including rigorous surgeon and nurse training and standardized care protocols, was established. Data on operative metrics, complications, and patient outcomes were analyzed, and patient well-being was assessed via a postoperative phone survey.
Results: Six surgeons and thirty nurses were trained, with surgeons completing a minimum of 20 h of simulation. Preoperative and operative times were significantly reduced through this process. Comparing the first 10 operations to the second, docking time decreased from 11.4 ± 4.1 min to 7.1 ± 2.1 min (p=0.0144) and operative time improved from 130.5 ± 25.7 min to 99.7 ± 21.8 min (p=0.0134). Mean intraoperative blood loss was minimal, averaging 19.5 ± 31.4 mL, and the average length of hospital stay was 3.1 ± 1.4 days. Postoperative pain levels were low, and patient satisfaction was high, as assessed by telephone survey.
Conclusions: Our findings highlight the value of the IDEAL framework in guiding the systematic evaluation and implementation of new surgical technologies such as the Dexter^® robot. A structured approach is essential to improve patient outcomes and safety in the coming digital transformation of surgery.

Extracellular matrix substrates differentially influence enteric glial cell homeostasis and immune reactivity

2025-07-29T10:50:57Z

Extracellular matrix substrates differentially influence enteric glial cell homeostasis and immune reactivity Schneider, Linda; Schneider, Reiner; Hamza, Ebrahim; Wehner, Sven Introduction: Enteric glial cells are important players in the control of motility, intestinal barrier integrity and inflammation. During inflammation, they switch into a reactive phenotype enabling them to release inflammatory mediators, thereby shaping the inflammatory environment. While a plethora of well-established in vivo models exist, cell culture models necessary to decipher the mechanistic pathways of enteric glial reactivity are less well standardized. In particular, the composition of extracellular matrices (ECM) can massively affect the experimental outcome. Considering the growing number of studies involving primary enteric glial cells, a better understanding of their homeostatic and inflammatory in vitro culture conditions is needed.
Methods: We examined the impact of different ECMs on enteric glial culture purity, network morphology and immune responsiveness. Therefore, we used immunofluorescence and brightfield microscopy, as well as 3’ bulk mRNA sequencing. Additionally, we compared cultured cells with in vivo enteric glial transcriptomes isolated from Sox10^iCreERT2Rpl22^HA/⁺ mice.
Results: We identified Matrigel and laminin as superior over other coatings, including poly-L-ornithine, different lysines, collagens, and fibronectin, gaining the highest enteric glial purity and most extended glial networks expressing connexin-43 hemichannels allowing intercellular communication. Transcriptional analysis revealed strong similarities between enteric glia on Matrigel and laminin with enrichment of gene sets supporting neuronal differentiation, while cells on poly-L-ornithine showed enrichment related to cell proliferation. Comparing cultured and in vivo enteric glial transcriptomes revealed a 50% overlap independent of the used coating substrates. Inflammatory activation of enteric glia by IL-1β treatment showed distinct coating-dependent gene expression signatures, with an enrichment of genes related to myeloid and epithelial cell differentiation on Matrigel and laminin coatings, while poly-L-ornithine induced more gene sets related to lymphocyte differentiation.
Discussion: Together, changes in morphology, differentiation and immune activation of primary enteric glial cells proved a strong effect of the ECM. We dentified Matrigel and laminin as pre-eminent substrates for murine enteric glial cultures. These new insights will help to standardize and improve enteric glial culture quality and reproducibility between in vitro studies in the future, allowing a better comparison of their functional role in enteric neuroinflammation.

Publikationen

Shortcoming of the Mouse Model of Postoperative Ileus

AI-Enhanced 3D Models in Global Virtual Reality Case Conferences for Surgical Care in a Low-Income Country

IDEAL–compliant implementation of the Dexter® surgical robot in cholecystectomy

Extracellular matrix substrates differentially influence enteric glial cell homeostasis and immune reactivity

IDEAL–compliant implementation of the Dexter^® surgical robot in cholecystectomy