JMIR Perioperative Medicine

Orthopedic trauma skills training is time-consuming and expensive. Current training modalities rely heavily on synthetic bone models, anatomical laboratory simulations, or assistance in surgeries (the apprenticeship model). Virtual reality (VR) appears to present a promising complement to current training modalities.

Artificial intelligence (AI) models are being increasingly integrated into clinical care. Moreover, the availability of publicly accessible AI resources makes them attractive to patients seeking clinical information. Little is known regarding the use of large language models as patient resources for navigating major cancer diagnoses.

There is mounting evidence to suggest that immersive virtual reality (IVR) can improve pain in older adults in community settings, yet the use of IVR postoperatively in the acute postoperative period following major elective abdominal surgery remains largely underexplored.

Measuring the optic nerve sheath diameter (ONSD) with ultrasound is a promising, noninvasive way to estimate intracranial pressure (ICP). While magnetic resonance imaging (MRI) provides high-resolution imaging, it is less accessible in urgent or perioperative settings. Comparing ONSD measurements between ultrasound and MRI may help confirm the use of ultrasound in neurosurgical patients.

Surgical education has shifted from the traditional Halstedian apprenticeship model toward incorporating simulation due to work-hour restrictions, increasing case complexity, and economic and liability pressures. Building on the success of the Fundamentals of Laparoscopic Surgery program for general surgery, the Fundamentals of Arthroscopic Surgery Training (FAST) program was developed to establish proficiency benchmarks for orthopedic trainees in basic arthroscopic skills.

Laparoscopic-guided subcostal transversus abdominis plane (TAP) block has been introduced as a surgeon-performed approach to postoperative analgesia in laparoscopic cholecystectomy (LC), allowing direct visual confirmation of local anesthetic delivery without ultrasound guidance. However, evidence regarding its clinical outcomes, particularly in patients with complicated gallstone disease, remains limited.

Virtual reality (VR) is a novel technology with implications for pain and sensory processing. VR may serve as a novel, scalable method to deliver clinically validated therapy for pain management as an alternative or adjunct to opioids for acute pain. Given that psychological factors and pain perception are both components of postoperative pain, it may also be beneficial to incorporate modalities that decrease anxiety, such as active relaxation and guided meditation with VR. Unfortunately, these therapies are not widely available due to multiple barriers. VR has the potential to deliver pain-reducing, psychologically based therapy to children, thereby enhancing multimodal analgesia and potentially decreasing opioid use. This study investigates the role of VR in reducing pain and anxiety after surgery. Given the substantial risks associated with opioid use, particularly in younger populations, alternative pain management strategies are crucial.

Total knee arthroplasty (TKA) is the primary treatment for advanced knee osteoarthritis. Despite its clinical success and favorable patient-reported outcome measures (PROMs), approximately 20% to 30% of patients continue to experience persistent functional limitations and muscle weakness. This highlights the need for a comprehensive evaluation of recovery parameters beyond pain and range of motion. Given the wide range of methods available for assessing TKA outcomes, clinicians often select tools based on personal preference and understanding, which may affect accuracy and consistency; for example, the Knee Injury and Osteoarthritis Outcome Score may overestimate function compared to gait analysis studies.

Traditional statistical models often fail to capture the complex dynamics influencing survival outcomes in patients with bladder cancer after radical cystectomy, a procedure where approximately 50% of patients develop metastases within 2 years. The integration of artificial intelligence (AI) offers a promising avenue for enhancing prognostic accuracy and personalizing treatment strategies.

Enhanced Recovery After Surgery (ERAS) programs bundle evidence-based interventions to standardize care, expedite recovery, and improve outcomes. As ERAS programs have expanded it has become clear that a major challenge is monitoring compliance of bundle elements and outcomes to feedback performance to stakeholders and guide changes. Manual data abstraction is onerous and not feasible. Reliance on receiving new reports from busy health system information technology (IT) groups is challenging. Therefore, we sought to address this unmet need at our hospital by developing a novel ERAS Datamart system.

Hypothermia, defined as a core body temperature below 36°C, is a common postoperative complication associated with adverse outcomes such as delayed wound healing, infections, and increased bleeding.

Perioperative patient-reported outcomes (PROs) allow patients to share their experiences of surgical procedures with their healthcare teams using standardized measures. Despite increasing recognition of their value, PROs are not routinely used in clinical practice, partly due to limited evidence of their impact on traditional clinical outcomes and uncertainty among clinicians about their utility. Digital health tools offer a promising way to integrate PROs into clinical workflows and enhance patient-clinician interaction, but their success depends on person-centered design to ensure usability and relevance. Safe Surgery South Africa, a non-profit organization, developed the Perioperative Shared Health Record (PSHR), a secure web-based tool that enables patients to share personal health information and PROs with their anaesthetist and surgeon before and after surgery. Initial implementation revealed significant user experience challenges, which contributed to poor uptake.