Surgical Pioneering Podcast Podcast Por Dr. Reza Lankarani arte de portada

Surgical Pioneering Podcast

Surgical Pioneering Podcast

De: Dr. Reza Lankarani
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"Surgical Pioneering Surgical Frontiers: Pioneering Tech Transforming Surgical Care" Mission Statement: Welcome to Surgical Frontiers, a global nexus for surgeons, researchers, engineers, and healthcare innovators dedicated to advancing surgical care through groundbreaking technology. This group is not just a platform—it’s a movement. Here, we explore, debate, and champion the innovations redefining the art and science of surgery. From AI-driven diagnostics to robotic-assisted procedures, augmented reality (AR) surgical navigation, and bioengineered implants, we are the vanguard of a new era in medicine. If you’re driven by curiosity, excellence, and the relentless pursuit of better patient outcomes, you belong here. --- Our Core Values: 1. Innovation First Surgery is no longer confined to scalpels and sutures—it’s a fusion of biology, engineering, and data science. We prioritize discussions on emerging technologies (e.g., nanorobotics, AI-powered predictive analytics, 3D bioprinting) and their real-world applications. Share prototypes, clinical trial results, or even bold hypotheses—if it pushes boundaries, we want to hear it. 2. Collaboration Over Competition Breakthroughs happen when diverse minds unite. Surgeons, engineers, ethicists, and entrepreneurs are all equal stakeholders here. Whether you’re a seasoned robotic surgeon or a startup founder developing smart OR tools, your perspective matters. Let’s dismantle silos and co-create solutions. 3. Evidence-Based Excellence Pioneering doesn’t mean reckless. We demand rigor. Posts about new tools or techniques should be grounded in peer-reviewed research, clinical data, or transparent case studies. Anecdotes are welcome, but they must spark deeper inquiry, not replace it. 4. Patient-Centric Ethics Technology is a means, not an end. Every innovation must answer: How does this improve patient safety, accessibility, or outcomes? We encourage tough conversations about cost, equity, and unintended consequences. Glorifying "tech for tech’s sake" has no place here. 5. Global Perspective Surgical challenges vary wildly between a high-resource urban hospital and a rural clinic. Share insights from low-income regions, disaster zones, or underserved communities. Innovation thrives when we solve for the margins, not just the mainstream. --- What You’ll Find Here : - Breakthrough Technologies: Deep dives into robotics, AI/ML applications, AR/VR surgical training, IoT-enabled devices, and beyond. - Expert Insights: Q&As with thought leaders, interviews with FDA regulators, and AMAs (Ask Me Anything) with pioneers. - Case Studies: How a hospital in Kenya adopted portable robotic tools, or how a Boston team used AI to reduce post-op infections by 40%. - Ethical Debates: Should AI diagnose surgical complications? Who owns data from smart implants? - Resource Sharing: Grants, conferences (e.g., SAGES, AACR), and regulatory updates. --- Why Join? - Learn: Weekly summaries of JAMA Surgery or Annals of Surgery highlights. - Influence: Shape the future by beta-testing tools, joining global consortia, or advising startups. - Grow: Mentorship threads for residents, grants for underrepresented innovators, and hackathons. --- The Future We’re Building: Imagine a world where: - A surgeon in Mumbai receives real-time AR guidance from a specialist in Toronto. - Bioprinted organs eliminate transplant waitlists. - AI predicts surgical complications before the first incision. "This isn’t science fiction—it’s the horizon we’re sprinting toward." Let’s pioneer responsibly. Let’s operate fearlessly. Post, comment, and collaborate. The next surgical revolution starts here. — Reza Lankarani M.D Founder & Curator, Surgical Frontiers "Surgical Pioneering Surgical Frontiers: Pioneering Tech Transforming Surgical Care"

lankarani.substack.comReza Lankarani Enfermedades Físicas Higiene y Vida Saludable
Episodios
  • "Burns and Mental Health: A Matched Cohort Study"

    "Burns and Mental Health: A Matched Cohort Study"
    Jul 16 2025

    Reviewed by Reza Lankarani M.D

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    Published online June 2025

    DOI: 10.1097/SLA.0000000000006270

    Annals of Surgery

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    This large-scale matched cohort study investigates the long-term association between burn injuries and mental health hospitalizations over 33 years. Analyzing 23,726 burn patients and 223,626 controls from Quebec, Canada, the study found that burn survivors had a 1.76-fold increased risk of mental health hospitalization compared to controls, with risks persisting up to 30 years post-injury. Severe burns (≥50% body surface area, third-degree burns, skin graft requirements) were linked to higher risks (HR: 2.00–3.29). Notably, burn patients exhibited elevated risks for eating disorders (HR: 3.14), substance use disorders (HR: 2.27), and suicide attempts (HR: 2.42), particularly within the first 5 years after injury.

    Comprehensive Data Linkage:

    - Utilizing population-based registries allowed for accurate tracking of hospitalizations and covariates, including socioeconomic status and preexisting conditions. This reduces selection bias and enhances generalizability within publicly funded healthcare systems.

    Subgroup Analyses:

    - Detailed stratification by burn severity (e.g., body surface area, degree, graft requirements) and mental health outcomes strengthens the validity of associations. For example, severe burns requiring grafts showed a 2-fold higher risk of hospitalization, highlighting the dose-response relationship between injury severity and mental health outcomes .

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    Comparison with Recent Studies:

    - Short-Term vs. Long-Term Risk:

    Earlier studies (e.g., Bich et al., 2021) reported elevated psychiatric risks up to 5 years post-burn , while this study extends the timeline to 30 years, corroborating longitudinal data from Abouzeid et al. (2022) on chronic mental health decline .

    - Severity Gradient:

    Consistent with Logsetty et al. (2016), severe burns requiring grafts showed the highest mental health risks, emphasizing the need for targeted interventions in this subgroup .

    - Substance Use Disorders:

    The observed 2.14-fold increased risk for alcohol-related hospitalizations aligns with Mason et al. (2017), who linked burn-related chronic pain and opioid prescriptions to substance misuse .

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    In conclusion, this study exemplifies the value of population-based cohort designs in uncovering the chronic impacts of surgical conditions. It sets a foundation for future research aimed at improving holistic burn care. Burn units should adopt lifelong mental health monitoring protocols, with intensified surveillance in the first 5 years post-injury. Pain management strategies must balance efficacy with addiction prevention to mitigate substance use risks .

    --

    Reza Lankarani M.D

    #burnsandmentalhealth #mentalhealthresearch #burninjurypsychologicalimpact #burnsurvivorsmentalhealth #mentalhealthstudy #cohortstudy #burntraumaandpsychology #psychologicaleffectsofburns #mentalhealthsupport #burninjuryrecovery #mentalhealthawareness #traumaandmentalhealth #psychologicalresilienceburns #burninjurymentalhealthanalysis #healthresearch #mentalhealthoutcomes #burnrehabilitation #mentalhealthinterventions #healthcareresearch



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    2 m
  • "Comparison Between Endovascular and Surgical Treatment of Acute Arterial Occlusive Mesenteric Ischemia"

    "Comparison Between Endovascular and Surgical Treatment of Acute Arterial Occlusive Mesenteric Ischemia"
    Jul 15 2025

    Reviewed by Reza Lankarani MD

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    World Journal of Emergency Surgery

    https:/doi.org/10.1186/s13017-025-00616-4

    This prospective observational substudy of the AMESI cohort provides valuable insights into the complex management of acute arterial occlusive mesenteric ischemia (AMI), specifically superior mesenteric artery (SMA) occlusion. Crucially, the authors rigorously account for baseline severity of illness (APACHE II, SOFA, lactate, vasopressor/ventilator needs), a major confounder often inadequately addressed in prior literature.

    Their sophisticated statistical approach, including multivariable logistic regression adjusted for key severity markers, robustly demonstrates that the apparent mortality benefit of endovascular therapy in unadjusted analysis (15.7% vs. 45.8%) is largely attributable to patient selection favoring less severely ill patients for endovascular intervention.

    The finding that neither initial treatment modality (endovascular vs. surgical) nor the performance of revascularization itself was an independent predictor of mortality after adjustment challenges simplistic interpretations of previous retrospective data and guideline recommendations.

    The subgroup analysis of endovascular monotherapy effectiveness (66.6% success rate) and its stark mortality difference (2.9% effective vs. 41.2% insufficient) provides clinically relevant granularity, highlighting the critical importance of patient selection for this approach.

    The explicit inability to identify reliable time thresholds or lactate cut-offs (beyond normal ranges) for predicting endovascular success underscores the complexity of AMI pathophysiology and the limitations of isolated biomarkers or symptom duration in guiding therapy.

    The study's significant strengths are its prospective nature, adjustment for illness severity, multicenter representation, and transparent reporting of limitations.

    However, key limitations acknowledged by the authors must be considered: inherent selection bias in treatment assignment within an observational design, relatively small subgroup sizes (especially for failed endovascular monotherapy, n=17), potential heterogeneity in treatment protocols across centers, and missing data for severity scores in some patients.

    Despite these limitations, the study makes a substantial contribution by shifting the paradigm: it compellingly argues that the choice between endovascular and surgical intervention should prioritize the patient's overall physiological condition and the etiology of occlusion (embolism vs. thrombosis) over rigid adherence to symptom duration thresholds. It sets a crucial precedent for future studies by emphasizing the absolute necessity of detailed reporting and adjustment for baseline severity, symptom duration, and AMI subtype to generate truly evidence-based management guidelines.

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    Reza Lankarani M.D

    #endovasculartreatment #surgicaltreatment #arterialocclusivemesentericischemia #acutemesentericischemia #vascularsurgery #minimallyinvasivesurgery #mesentericischemiamanagement #endovasculartherapy #surgicalintervention #mesentericartery #ischemiadiagnosis #vascularintervention #emergencybowelischemia #treatmentcomparison #mesentericischemiaoutcomes



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    2 m
  • "Vagilangelo, Innovation or Exploitation in Women’s Health Deep Dive Podcast"

    "Vagilangelo, Innovation or Exploitation in Women’s Health Deep Dive Podcast"
    Jul 13 2025
    The provided sources, primarily critiques from an OBGYN and health disparities researcher, Dr. Reza Lankarani, highlight significant concerns regarding the Vagilangelo® procedure and the broader landscape of cosmetic gynecology, particularly in the context of medical tourism and training in Arab countries. The central theme revolves around the tension between profit-driven healthcare and patient safety, arguing that the commercialization of uncertainty in women's health is exploitation, not innovation.1. The Vagilangelo® Procedure: Unsubstantiated Claims and Evidence DeficitThe Vagilangelo® procedure, marketed as a revolutionary vaginal rejuvenation technique, aims to restore "natural vaginal angulation" through internal suturing and platelet-rich plasma (PRP) injections. However, the sources assert that its claims are largely unsubstantiated by scientific evidence.Lack of Peer-Reviewed Validation: Despite claims of "77% satisfaction," Dr. Lankarani's critical review notes: "High satisfaction rates cited are anecdotal... Clinical trials comparing it to established methods would significantly strengthen its standing." The procedure lacks "zero randomized controlled trials," "no longitudinal safety data," and "absence of objective outcome measures (e.g., validated sexual function scales)."Unproven Biological Mechanisms: The efficacy of PRP for vaginal sensitivity lacks "tissue-specific evidence," and its growth factor concentrations and injection protocols are not standardized. This "scientific overreach" contrasts with established therapies that have documented effects.Inadequate Structural Correction: Marketing materials state Vagilangelo® provides "less tightening than traditional vaginoplasty," making it unsuitable for significant prolapse or laxity, positioning it as a "solution" for problems it cannot adequately address.Unquantified Risks: Unlike traditional surgeries with documented complication rates (e.g., vaginoplasty stenosis rates: 5–15% at 5 years), Vagilangelo® lacks published data on intraoperative risks, long-term safety, or pain management. The use of internal sutures poses theoretical risks of "urethral/bladder injury" and "nerve damage."2. The Exploitative Ecosystem: Medical Tourism and Predatory TrainingThe sources heavily criticize the "exploitative cosmetic surgery tourism" and "unethically trained practitioners" associated with procedures like Vagilangelo®, particularly targeting vulnerable women in low-resource settings like Bahrain.Medical Tourism's Hidden Costs: Bahrain's experience shows that its tertiary centers absorb significant costs (175,000 USD annually) treating complications from cosmetic tourism, mostly infections and implant failures. "All-inclusive packages" typically exclude meaningful postoperative care, leading to "patient abandonment" and an "economic drain" on local healthcare systems.Unethical Training Paradigms: The rise of "short-course 'fellowships'" (e.g., 3-5 day "certification" programs in Arab countries) enables this crisis. These programs lack "standardized curricula" and bypass the 1-2 years of supervised training required for legitimate surgical fellowships. They are accused of "targeting vulnerable populations" and allowing "underqualified surgeons operating on poor women," which is deemed "ethical malpractice."Commercialization of Insecurity: Vagilangelo® marketing is seen as violating core bioethical principles by prioritizing profit over documented clinical benefit. Patients cannot provide meaningful consent due to a lack of outcome data, and the high cash-pay cost ($3,000+) excludes low-income women who might need functional repair.3. Ethical Violations and Health DisparitiesThe commercialization of procedures without robust evidence is seen as contributing to global health inequity and ethical failures.Autonomy Violation: Patients cannot provide meaningful consent without comprehensive, evidence-based information on risks and benefits.Justice Failure: The high cost excludes low-income women who might benefit more from affordable, evidence-based functional repairs.Beneficence Abandonment: The emphasis on profit over documented clinical benefit is a betrayal of the medical principle of beneficence.Regressive Healthcare Subsidy: Public hospitals bear the burden of complications from offshore cosmetic procedures, effectively subsidizing a profit-driven industry.4. Policy Recommendations: Toward Ethical PracticeThe sources propose a multi-faceted approach to address these issues, emphasizing regulatory harmonization, patient safety integration, and ethical commercialization.Evidence and Regulation Reform: This includes an "immediate moratorium on Vagilangelo® marketing pending RCTs," standardization of outcome measures by professional bodies (e.g., ACOG/FIGO), and "FDA-equivalent oversight of PRP preparation protocols."Training and Equity Measures: Recommendations include a "global ban on <3-month cosmetic surgery 'fellowships'," mandatory ...
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    14 m
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