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Zeitschrift Open Access

Innovative Surgical Sciences

The Journal of the German Society of Surgery

Editor-in-Chief: Udo Rolle
Wissenschaftlicher Beirat: Adam Dziki , Karl-Walter Jauch , Martin S. Karpeh , Masaki Kitajima , Paul Mansfield , Tim Pohlemann , John Primrose und Yang Hang-Kwang

Sprache: Englisch

Erstveröffentlichung: 1. März 2016

Erscheinungsweise: 4 Hefte pro Jahr

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Objective
Increased social demands for a free access to information and the initiative of international research-funding institutions (Berlin Declaration) encouraged the German Society of Surgery to launch a new open access surgical journal entitled Innovative Surgical Sciences – The Rapid Journal of the German Society of Surgery. It is the aim of the journal to create the future of free digital information to the surgical community worldwide in order to promote surgical and scientific knowledge.

Innovative Surgical Sciences (ISS) is an open access, peer-reviewed journal and welcomes english language Original Articles, Reviews and Case Reports covering clinical and experimental studies in all surgical sub-specialties. ISS also publishes Guidelines and Recommendations, Perspectives, Opinion Papers and Letters to the Editor. All contributions submitted for publication are double-blind reviewed by at least two renowned experts in the field, selected and invited by the Editor-in-Chief. All submissions will be subject to a rapid, initially double-blind peer-review process, allowing a first decision to be reached within 30 days of submission. For submissions accepted for publication, the complete reviewer reports and author response letter(s) will be published as supplementary material and as part of the article record.

Topics

general surgery
digestive surgery
vascular surgery
pediatric surgery
oral - maxillofacial surgery
neurosurgery
orthopedic surgery
plastic, reconstructive and aesthetic surgery
thoracic surgery
heart surgery
trauma surgery
clinical and experimental research

Article formats
ISS welcomes english language Original Articles, Reviews and Case Reports covering clinical and experimental studies in all surgical sub-specialties. ISS also publishes Guidelines and Recommendations, Perspectives, Opinion Papers and Letters to the Editor.

Article Processing Charges
In order to sustain the quality of our fully refereed open access journal, each article accepted for publication in Innovative Surgical Sciences is subject to an Article Processing Charge (APC) of 1,000 EUR. If you are a member of the German Society of Surgery, or you have been acquired as author by the Editor-in-Chief,　a board member of the journal or being invited to a special issue of the journal, you will not be asked to pay for your submission. In these cases the German Society of Surgery will cover the processing charges. In addition, the German Society of Surgery will continue to support all authors of unsolicited manuscripts, meaning that the APC rate for 2024 and 2025 will be reduced to 400 EUR.

Ihre Vorteile

Dear Authors

You are kindly invited to contribute to the next issues of Innovative Surgical Sciences.

Your benefits:

Imperative topics
State-of-the-art studies in all surgical sub-specialities
Clinical and experimental approach
Renowned international editors and editorial board
High quality peer-review
Reviewer assessment available

Innovative Surgical Sciences is the OPEN ACCESS JOURNAL of the GERMAN SOCIETY OF SURGERY.

Please submit your manuscript here

Geschichte

The open access journal Innovative Surgical Sciences (ISS) was founded in 2016 by the German Society of Surgery encouraged by the increased social demands for free access to information and the initiative of international research-funding institutions (Berlin Declaration).

Other publications in the field

Open Access
Current status and future developments in dental implantology – a narrative review

18. September 2025

Constanze Friedrich, Constantin Graw, Juliane Kröplin

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Introduction The vast majority of people are affected by tooth loss in the course of their lives. Dental implants are used to anchor prosthetic teeth and represent the gold standard for replacing missing teeth. As the preservation of chewing function and esthetics has a significant influence on the quality of life, the constant further development of techniques and materials is a central issue in oral and maxillofacial surgery. This narrative review article aims to evaluate the historical development, current status, and innovative methods of dental implants. Content A selective literature search based on Pubmed was conducted, focusing primarily on literature from the years 2023 to 2025. Keywords used in the search were “dental implants” in combination with “navigation” and “virtual surgical planning.” Summary The causes of tooth loss, the anatomical conditions of the jaw, and possible treatment approaches for oral rehabilitation are diverse and require individual consideration depending on the individual patient situation. In any case, the use of materials and geometries supporting the osseointegration of the implants, the optimal positioning of the implants in the jawbone, and surgery procedures that are as atraumatic as possible are fundamental to successful implantation. In recent years, digital and technical innovations have changed the way treatment is planned and performed. The shift toward an increasingly digital workflow has resulted in more efficient planning and improved precision in implant positioning. This is associated with improved clinical results and more satisfied patients. Outlook In this study, the field of dental implantology is reviewed and future opportunities and challenges are identified. Despite the fact that this will result in new obstacles, dental implantation can become increasingly precise and efficient thanks to the development of digital technologies such as Augmented Reality-Assisted Navigation and autonomous dental implant robots.
Open Access
Pelvic insufficiency fractures in the elderly – what insights has the past year of research brought? A narrative review

18. September 2025

Kim Lydia Klepka, Christian Kleber, Yasmin Youssef

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Pelvic insufficiency fractures (PIFs) are low-energy fractures typically occurring in osteoporotic bone and are associated with significant morbidity, reduced quality of life, and increased mortality. PIF requires individualized, often interdisciplinary treatment strategies combining surgical, conservative, and systemic approaches. This narrative review aims to summarize recent findings on the diagnosis, management, and outcomes of PIFs and place them in the context of existing literature. For this purpose, a selective literature search was conducted in January 2025 to identify publications on the topic of PIFs. The search was performed on PubMed and clinical studies addressing the diagnosis, treatment, outcomes and complications of PIFs from January 2024 to 2025 were selected for evaluation. A total of 11 studies with a total of 27,672 patients were included in this review. The findings emphasise the significant morbidity, mortality and healthcare burden associated with these fractures. Conventional radiography frequently fails to detect this type of fracture, thus necessitating advanced imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI) to ensure an early diagnosis. The treatment decision is determined by the stability of the fracture, presence and intensity of pain, and the patient’s mobility levels. The treatment options, whether conservative or surgical, are adapted to these factors. The osteoporotic fracture (OF) Pelvis Score has emerged as a promising tool for guiding therapeutic strategies, though there is still potential for further development in the use of pharmaceutical treatment of underlying conditions such as osteoporosis. Despite the advances that have been made, the existing literature remains heterogeneous, underscoring the importance of conducting prospective studies and developing evidence-based guidelines. Interdisciplinary and orthogeriatric care is important for improving outcomes for this vulnerable patient group.
Open Access
Recent advances in operative techniques for pancreatic surgery

18. September 2025

Johanna Strotmann, Verena Tripke

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Introduction Pancreatic resections are one of the most complex operations in visceral surgery, characterized by high perioperative morbidity and mortality. Continuous evaluation and adjustment of surgical techniques and approaches are required to improve the quality of surgery and outcomes in this highly vulnerable collective of patients. Content In this short narrative review we will discuss exemplary three recent advances in pancreatic surgery. Summary and Outlook A systematic literature search was performed using the PubMed database. The three discussed promising developments in pancreatic surgery are the triangle operation, a radical resection of lymphatic and nerve tissue in patients with pancreatic cancer, autologous patches for covering skeletonized arteries after resection to reduce frequent postoperative complications, and minimal invasive surgical approaches, which offer potential benefits in reduced intraoperative blood loss, shorter hospital stay and lower rate of wound infections compared to open resections. These three new operative approaches represent promising advances in a demanding surgical field. However, further studies are needed to confirm the benefits of these techniques on patient outcomes.
Open Access
Postoperative outcomes of inguinal hernia repair performed by surgical residents in routine clinical practice: a retrospective single-center analysis

18. September 2025

Helga Oehler, Kim L. Zerr, Hanan El Youzouri, Ursula Pession, Wolf O. Bechstein, Armin Wiegering, Teresa Schreckenbach

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Objectives Inguinal hernia repair is one of the most common surgical procedures performed worldwide. As part of training, surgical residents perform these procedures, which raises questions about the safety and efficacy of their involvement compared to specialists. This study compares the postoperative outcome and complications of inguinal hernia repairs conducted by residents under supervision with those performed by board certified surgeons independent of the method of surgery. Methods This retrospective cohort study was performed at a single tertiary care center. 388 patients undergoing inguinal hernia repair, aged 18 years and older were included. Data were collected from 2014 to 2020. Results The techniques used for the hernia repair were open repair using the Lichtenstein technique (n=159) and the transabdominal preperitoneal (TAPP) mesh technique (n=228). The hernia repairs were mostly performed as an open procedure by residents (n=72; 45 %), whereas board-certified surgeons mostly operated laparoscopically (n=190; 83 %). Surgical trainees had significantly longer operation times when performing a laparoscopic procedure than attending surgeons (means: 94 vs.70 min; p <0.001). However, there was no difference in operation time when an open procedure was performed ( p =0.988). Univariate analyses revealed no influence of the level of training on overall postoperative morbidity ( p =0.138) but showed that the TAPP technique was a protective factor for postoperative complications ( p <0.001). Conclusions Resident participation in inguinal hernia repair is safe and does not increase postoperative complications. In the tertiary care center, residents primarily performed open repairs, while board-certified surgeons favored the minimally invasive approach. Both techniques proved to be safe under appropriate supervision. These findings highlight the feasibility of structured surgical training in routine clinical practice, ensuring patient safety while maintaining high educational standards.
Open Access
Student-led curriculum design and teaching by fellow students provide a feasible platform for surgical identity and a gateway to surgical careers

5. August 2025

Hajera Khaleqi, Kira Meißner, Abdulrahman Al-Harazi, Kim Lea Seifert, Lara Čierná, Maxim Popov, Gaby Lee, Antonia Reers, Saman Keshtkaran, Pauline Schuppert, Florian Rapp, Lucas Cröpelin, Martin Oertel, Fabian Pascal Schönewald, Jenna Sophie Schöllhorn, Atiehalsadat Nasr Esfahani, Tobias Dust, Judith Stolz, Andreas Lindner, Anas Amin Preukschas, Felix Nickel, Amila Cizmic, Melanie Le, Michael Sennert, Konrad Reinshagen, Christian Tomuschat, Hans Christian Schmidt

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Objectives Simulation-based (SBT) training is an essential component of modern surgical education as it improves both technical and non-technical skills while increasing the motivation of medical students. This study investigates the implementation of a student-led SBT based on peer teaching to overcome challenges in surgical education, maintain motivation, and facilitate access to surgical professions. Methods From January 2024 to December 2024 a student-led voluntary course on basic laparoscopic techniques was performed, in which medical students from all semesters could participate. Satisfaction, motivation, and perceived openness for surgical professions of the participants were assessed using questionnaires and evaluated descriptively. Results Eighty six medical students were trained in basic laparoscopic skills. The main reasons for participating were the desire for practical training (80 %), interest in laparoscopic techniques (76 %), and the pursuit of a surgical career (56 %). Overall satisfaction was high ( M =4.88/5). After the course, participants felt better prepared for clinical internships (87 %) and said they are more likely to pursue in the surgical field (74 %). Conclusions Peer teaching in a non-institutionalized, exam-free environment shows considerable potential for promoting surgical identity in medical students. The results underscore the importance of voluntary, creative training formats to support motivation, competence development, and identity formation in surgery.
Open Access
Arthroplasty for post-traumatic carpometacarpal joint (CMC) V osteoarthritis with minced cartilage: a case report

16. Juli 2025

Vincent März, Martynas Tamulevicius, Peter Maria Vogt, Frederik Schlottmann

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Objectives Fractures and dislocations of the bases of the fourth and fifth metacarpal bones are rare, accounting for <1 % of all hand injuries. If left untreated or inadequately fixed, there is a risk of persistent pain, functional impairment, and post-traumatic osteoarthritis. While common surgical approaches such as arthrodesis or suspension arthroplasty have been described, data on alternative treatment options remain limited. Case presentation This case report presents the first documented use of minced cartilage for treating post-traumatic CMC V osteoarthritis. A 17-year-old patient experienced persistent pain following fracture fixation with K-wires. After debriding arthrotomy, cartilage was harvested from the hamate bone, minced, and combined with platelet rich plasma before implantation. One year postoperatively, the patient showed improved joint space, complete pain relief, and restored hand function. Conclusions Preliminary results suggest that minced cartilage may offer a promising alternative, but further studies are needed to confirm its long-term efficacy.
Open Access
Comprehensive interdisciplinary treatment of an orbital lymphatic-venous malformation: a case report

30. Juni 2025

Céline Tourbier, Bilal Msallem, Martin Thanh-Long Takes, Florian M. Thieringer, Lukas B. Seifert

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Objectives Orbital lymphatic-venous malformations (LVMs) are rare congenital anomalies that can cause significant functional and aesthetic impairments. Case presentation This case report details the comprehensive treatment of a 47-year-old male with a longstanding orbital combined slow-flow vascular malformation. Diagnostic evaluation included magnetic resonance imaging and a sonographically guided core needle biopsy, which confirmed a benign lymphatic-venous malformation. The treatment started with minimally invasive sclerotherapy to reduce lesion size, followed by surgical debulking to alleviate proptosis and mechanical restrictions. Finally, reconstructive surgery addressed residual eyelid deformities, including ectropion and ptosis. Post-treatment outcomes demonstrated stable visual function, improved eyelid position, and a significant enhancement in the patient’s aesthetic appearance and quality of life. Conclusions The staged, multimodal approach underscores the importance of individualized treatment planning and interdisciplinary collaboration. This case highlights the potential for excellent functional and aesthetic outcomes in the management of complex orbital LVMs when nonsurgical and surgical techniques are strategically combined.
Open Access
Who takes the lead in oral surgery simulation? Students’ perceptions and practical skills towards virtual reality and phantom model training: a comparative study

26. Juni 2025

Juliane Kröplin, Constanze Veronika Friedrich, Lisa Harms, Ingo Buttchereit, Jan-Hendrik Lenz, Bernhard Frerich

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Objective Virtual reality (VR) simulators are considered a promising tool for significantly enhancing surgical skills. This study aims to compare the use of a VR simulator with a conventional phantom model in oral surgery training. The findings should contribute to the further development of oral surgery simulation training and help maximize the innovative benefits of VR-based training. Methods This prospective, cross-sectional, single center study analyzed students’ competence in performing an osteotomy on a displaced tooth 38. Participants were dental students in their 5th semester at a University Medical Center in Germany. The study compared a VR simulator with a phantom model. After completing the exercise, students filled out a questionnaire consisting of both standardized and open-ended questions to allow for a comprehensive subjective evaluation of the training experience. Results A total of 22 students took part in the study (12 female, 10 male). None had previously performed the exercise on a patient. From the students’ perspective, both training methods were easy to learn (VR:2.0; Ph: 2.1; p=0.642). Individual feedback highlighted that the VR simulator’s main advantages were sustainability (n=12) and objectivity (n=5). However, standardized responses indicated that the phantom model was rated as more realistic, particularly regarding anatomical representation (p<0.001), haptic feedback (p<0.001) tooth removal (p<0.001) and osteotomy steps (p<0.001). Both exercises were equally engaging for students (VR:1.8; Ph:1.5; p=0.162). Conclusion Simulation-based training is an engaging way for students to learn surgical tooth removal. Currently, conventional simulation is subjectively perceived as superior to VR simulation, particularly in terms of realism. However, VR simulation allows for a more objective assessment of performance and is considered superior to the phantom model in terms of sustainability. Further technological advancements and improvements in realism could help maximize the innovative benefits of VR-based training.
Open Access
Microsurgical training on non-living models: proposal for basic training

3. Juni 2025

Mara Franza, Giovanni Maria D’Antonio, Anna Barbara Di Stefano, Emanuele Cammarata, Giovanni Zabbia, Francesca Toia

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Objectives Microsurgery is an essential skill for plastic surgeons and a basic microsurgical course should be integrated into all plastic surgery residents’ training programs, as mastering this technique cannot be reached only through observation and requires regular practice. Despite living models better simulate reality, non-living models have been shown to be valid tools for basic/intermediate microsurgical training. While many single preclinical exercises are described in the literature, there is lack of proposals for a complete basic program on non-living models. The aim of this study is to propose a basic microsurgical program entirely based on non-living models and to evaluate its feasibility with a cross-sectional study that analyses the outcomes of its application via the “Queen Mary University London microsurgery global rating scale” scoring system. Methods Nine different exercises for microsurgical training on non-living models were chosen based on a literature review. A basic step-by-step microsurgical training program was built. The program was proposed to the Plastic Surgery residents of our unit through a five-day training, during 2020–2023. No participants ‘selection was made. All participants were examined with a practical test before and after the proposed program. The results of pre- and post-training test were collected and analysed. Results Each trainee was able to complete a posterior-wall-first technique end-to-end anastomosis on the chicken thigh femoral artery with no major mistakes at the end of the program. Moreover, the data analysis revealed a statistically significant improvement of each evaluated skill after the training. Conclusions The proposed basic program is easy to organize and allows the trainee to develop the basic microsurgical skills needed to move to advanced training on living animals or on guided clinical practice.
Open Access
Hot water bottle burn injuries: a 10-year retrospective analysis of incidence and potential predictors in Germany

22. Mai 2025

Moritz Rudolf Milewski, Frederik Schlottmann, Anieto Onochie Matthias Enechukwu, Nico Franke, Martynas Tamulevicius, Louisa Jutta Dietz, Luis Alberto Barros Navarro, Lukas Wellkamp, Khaled Dastagir, Peter Maria Vogt, Vincent März

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Objectives Hot water bottles are widely used for warmth and therapeutic relief, but improper use can lead to burns, ranging from superficial to full-thickness skin injuries. Following the natural gas shortage caused by the complete halt of Russian gas supplies, European countries experienced a sharp increase in hot water bottle-related burns. However, data for Germany were not yet provided. This study examines the incidence of hot water bottle burns over a 10-year period, exploring potential correlations with natural gas prices, natural gas consumption, ambient temperature, and respiratory infection rates. Methods A retrospective single-center analysis of 88 patients who sustained hot water bottle burns from 2014 to 2024 was conducted. Patient data, including burn severity and demographic information, were extracted from hospital records. Monthly counts of acute respiratory infections (ARIs), ambient temperature, natural gas price and gas consumption data were also analyzed. A Poisson regression model was applied to assess the association between hot water bottle burns and the mentioned independent variables. Results The majority of burns (81.8 %) were second-degree injuries, primarily affecting women (81.8 %). Burns were most common on the lower trunk, thighs, and forearms. The Poisson regression model revealed that for every 1 °C increase in ambient temperature, the incidence of burns decreased by 7 % (IRR=0.93, 95 % CI: 0.88–0.97). However, no significant association was found between ARI incidence, natural gas price and burn occurrence. There was no significant increase of water bottle burns during the recent European energy crisis in Germany. Conclusions Hot water bottle burns are more frequent during colder months, particularly among women. Natural gas price or natural gas consumption seems like not playing an equivalent role in Germany as in other European countries. Public health efforts should focus on education and prevention strategies to reduce these preventable injuries. Further research should explore additional factors that may influence burn rates.
Open Access
Effectiveness and feasibility of short-course simulator training for robotic surgery novices – a randomized controlled trial (FastSim trial)

22. Mai 2025

Sotirios Emmanouilidis, Kürsat Kirkgöz, Tina Groß, Benjamin Müssle, Anna Klimova, Daniel Stange, Thilo Welsch

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Objectives As robot-assisted surgery (RAS) is on the rise, feasible and effective simulator training for surgical residents is needed. This study compares the effectiveness and feasibility of two compact simulator training protocols on the DaVinci skills simulator (dVSS) for preparing robotic surgery novices. Methods In this randomized controlled trial, RAS novices were randomized 1:1 into a conventional group (Control), including four repetitions of five simulator exercises in two sessions, and a fast group (Fast), with two repetitions of the same five simulator exercises in a single training session. The primary endpoint was the mean efficiency score achieved in the final exercise. Results Fifty-two participants (22 males) were randomized, 26 in each group. Forty-eight per cent were between 30 and 50 years old and most of the participants were residents (44.2 %) or consultants (42.3 %), 13.5 % were students. The primary endpoint results showed a mean efficiency score of 48.2 ± 26.7 (Fast) vs. 52.3 ± 30.4 (Control) in the intention-to-treat analysis (p=0.527). The most significant improvement in efficiency and penalty scores was observed between the 1st and 4th repetitions in the control group. Participants over 50 years old and consultants performed worse than younger participants, students and resident doctors. Participants interested in robotic surgery outperformed those with little or no interest. Conclusions A training of 10–20 exercises on the dVSS with ascending levels is insufficient to succeed in complex simulation exercises but improves performance and motivation. These findings emphasize the need for tailored training programs and continuous skill development in robotic surgery.
Open Access
Vascular considerations in autologous breast reconstruction using DIEP or MS-TRAM flaps: standard techniques, alternatives, and rescue strategies

22. Mai 2025

Theresa Promny, Andreas Arkudas, Paula Huberth, Raymund E. Horch

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Objectives Microsurgical breast reconstruction is an established method following mastectomy; however, various factors significantly influence the complication rate. This analysis evaluates the impact of vascular anastomosis techniques, previous surgeries, and radiotherapy on the success rate of microsurgical breast reconstruction. Methods In a retrospective data analysis of 396 patients who underwent 447 flap procedures (single or bilateral microsurgical breast reconstruction) using tissue from the lower abdomen (either DIEP or MS-TRAM flaps), the type of venous and arterial anastomoses, the initial findings or surgical specifics at the thoracic recipient site and their influence on complications were examined. Results Anastomosing two veins per flap did not result in a significant reduction of major complications. Flap loss was significantly more common when standard venous anastomosis to the internal mammary vein was not used, underscoring their role as the preferred recipient vessels. No major complications were observed in patients receiving a caudal anastomosis to the internal mammary artery. Patients with prior radiotherapy exhibited an increased need for arterial revisions. All documented seromas and infections occurred in irradiated patients. Conclusions A differentiated surgical plan that considers optimal anastomosis techniques, supercharging strategies, and individual risk factors is crucial to reducing complications. Further studies are needed to optimize patient-specific strategies.
Open Access
Adherence to an enhanced recovery protocol in colorectal surgery before and during a structured implementation – a prospective cohort study from nine German hospitals

22. April 2025

Wolfgang Schwenk, Christoph Strey, Sven Flemming, Monsserat Girona-Johannkämper, Wolfgang Wendt, Ibrahim Darwich, Hannes Neeff, Mark Banysch, Sandra Henn, Michael Scheruhn

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Objectives Enhanced recovery protocols (ERP) are considered as state of the art in perioperative management of elective colorectal resections. However, adoption of ERP in the clinical routine is not easy and a structured implementation process is recommended. The aim of the present data analysis was to evaluate the learning curve of the structured implementation of an enhanced recovery protocol in elective colorectal resections based on adherence to recommended ERP elements and clinical outcomes. Methods During a 12-month structured implementation of an ERP in nine hospitals, perioperative management data were prospectively documented. Patients during the 3-month preparation phase were differentiated as a comparison group with traditional management from patients during the clinical ERP implementation. In addition, the 9-month ERP application phase was divided into three equal sections. Adherence to 23 recommended ER elements and to the pre-, intra- and postoperative elements was calculated. Results One thousand one hundred fifty-three patients (48.3 % female) were included. Traditional perioperative treatments were applied in 313 patients (preERP), while 840 patients (249, 297 and 294 during months during the first [ERP3], second [ERP6] and last 3 months [ERP9] interval) were treated according to the enhanced recovery protocol. Overall preERP ERP-adherence was 52 (IQR: 48–57)% in 9 hospitals but increased to 87 (78–91)% at the end of ERP-implementation. Functional recovery after surgery increased from preERP to ERP9, and postoperative length of stay was reduced from 7 (6 – 8) to 5 (5 – 7) days. Major improvements in overall and preoperative ERP adherence were achieved during the first 3 months, while postoperative ERP adherence took 6–9 months to reach best results. Conclusions Structured implementation of an enhanced recovery protocol resulted in high adherence to 23 ERP-elements within 12 months. Although major achievements occurred during the first 3 months of clinical ERP utilization, a total of 9 months are needed especially to improve postoperative ERP-adherence.
Open Access
Heterotopic pancreas and malakoplakia in abscessing intrahepatic tumor – a case report

28. März 2025

Marc A. Reschke, Phil Meister, Sven A. Lang, Dirk Theegarten, Tom F. Ulmer, Hideo A. Baba, Ulf P. Neumann, Lara Heij, Sophia M. Schmitz

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Objectives The presence of heterotopic pancreatic tissue or malacoplakia in the liver is very uncommon and rarely becomes symptomatic. Case presentation Here we report of a 57-year-old female patient who received left-sided hemihepatectomy due to a tumor resembling intrahepatic abscess. Histopathological examination revealed both heterotopic pancreas and malakoplakia. Conclusions We discuss this case in relation to the existing literature. As far as we know, this is the first reported case of simultaneous presence of these two rare entities.
Open Access
Correlation of radiographic and histopathological changes with IL-17 and advanced oxidation protein products in knee osteoarthritic individuals with metabolic syndrome

10. Februar 2025

Uzma Naseer Awan, Rizwana Sanaullah Waraich, Syed Shahid Noor, Iftikhar Ahmed Siddiqui, Ruqaya Nangrejo

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Objectives Recent studies show that osteoarthritis and metabolic syndrome (MetS) represent significant global health concerns, sharing common pathological processes involving inflammation and oxidative stress. The study aimed to compare the radiological and histological severity of osteoarthritis in patients with and without MetS and further correlates them with oxidative stress and inflammatory markers in serum and synovial fluid (SF). Hypothesis: The study hypothesized that IL-17 and advanced oxidation protein products (AOPPs) are correlated with OA severity and progression in MetS patients. Methods This cross-sectional study included 78 patients of advanced knee osteoarthritis, 40 with MetS and 38 without, matched for age. Clinical history and anthropometric measurements were recorded, and presurgical knee X-rays were evaluated using the Kellgren–Lawrence system. Histological grading of hematoxylin & eosin stained infrapatellar fat pad (IFP) and cartilage sections was performed. AOPPs and Interleukin-17 levels were measured in serum and SF, employing sandwich enzyme-linked immunosorbent assay. Results In the MetS group, the severity of osteoarthritis was higher compared to non-MetS group, as evidenced by histological evaluation of the articular cartilage and IFP (p<0.05). The histological grading of IFP demonstrated positive correlation (p<0.05) with histological cartilage grade. Additionally, it exhibited a positive correlation with interleukin-17 and AOPPs in both SF and serum (p<0.05). While histological cartilage grade showed a positive correlation with AOPPs concentration in the serum and SF (p<0.05). Conclusions MetS accelerates osteoarthritis progression, and positive correlation between molecular markers and histological severity suggests the contribution of inflammation and oxidative stress in the disease’s pathogenesis.
Open Access
IDEAL–compliant implementation of the Dexter^® surgical robot in cholecystectomy: a comprehensive framework and clinical outcomes

30. Dezember 2024

Jonas Dohmen, Julia Weber, Jan Arensmeyer, Philipp Feodorovici, Jonas Henn, Joachim Schmidt, Jörg C. Kalff, Hanno Matthaei

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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.
Open Access
Influence of the COVID-19 pandemic on the amputation rate in Germany in patients with critical limb-threatening ischaemia

18. Dezember 2024

Wojciech Derwich, Oliver Schöffski, Eva Herrmann, Kyriakos Oikonomou

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Objectives The COVID-19 pandemic has shown a wide range of direct and indirect influences on the health of the population. This study examines the impact of the COVID-19 pandemic on the amputation rate in Germany in patients with critical limb-threatening ischaemia (CLTI). Methods The epidemiological, pooled, and anonymised data of 476,168 CLTI patients from the Institute for the Hospital Remuneration System (InEK) were analysed for 2019–2023 at the federal level at weekly intervals and compared with epidemiological data for COVID-19 patients from the Robert Koch Institute (RKI) database, divided into the pandemic phases. Results The number of inpatient cases declined by −4.64 % (p>0.05) from 2019 to 2020 and increased significantly by +7.07 % (p=0.001) from 2020 to 2023. The incidence of all lower limb amputations increased from 2019 to 2022 (23.9 vs. 25.7 %, p=0.01) with no significant changes in 2023. Moreover, the incidence of minor amputations increased from 16.9 % in 2019 to a maximum of 18.9 % (p<0.001) in 2022, and then to 18.4 % (p=0.02) in 2023. In the short-term perspective, inpatient cases significantly decreased in phases 1 and 3, with a relevant increase in the subsequent phases. However, the incidence of all amputations, especially minor ones, is constantly increasing. Conclusions The COVID-19 pandemic has significantly indirectly impacted the management of CLTI patients, with a marked increase in the incidence of minor amputations, presumably due to the delayed presentation of patients with small necroses and due to limited access to healthcare.
Open Access
Obstacles during training of pregnant doctors in Germany before and after COVID-19: is there a need for change?

13. Dezember 2024

Caroline Fortmann, Susanne Johna, Christiane Groß, Maya Niethard, Barbara Puhahn-Schmeiser, and, Maternity Protection Task Force

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Objectives With the growing proportion of female practitioners in the medical field, management of pregnant medical doctors is an increasingly important concern. The 2018 amendments to the German Maternity Protection Act stipulate that pregnant doctors and students can and should be permitted to safely continue their work under strict protective measures. Despite these measures, the reality is that pregnancy still results in limits on professional advancement and attainment for many physicians. To improve this situation, we analyzed the current situation in Germany. Based on our analysis, we identified some areas in need of improvement and offered recommendations. Methods We performed a nationwide online survey that was sent to medical doctors and students via the physicians’ union Marburger Bund members’ mailing list. The survey’s main focus was on which kinds of clinical duties the pregnant doctors were assigned to, subdivided into four different time periods (under the previous and amended Maternity Protection Act, during COVID-19 pandemic and after), from 2016 to 2022. Results Our survey included 4,748 female medical doctors and students, with a balanced distribution across the four different time periods. The most striking restriction reported by our participants was a ban on performing surgeries and invasive procedures, an experience reported by 57–65 % of pregnant doctors and medical students before the COVID-19 pandemic and nearly 80 % since the pandemic. In addition, since the COVID-19 pandemic, a complete employment ban has been enforced upon nearly 50 % of the pregnant doctors. More than 50 % of pregnant doctors considered their careers to have been obstructed or curtailed by their pregnancies prior to the pandemic, with that number growing to two-thirds since the pandemic. Conclusions Pregnancy negatively impacts doctors’ training and careers. Many women are not allowed to perform surgeries and invasive procedures, even while some of these practitioners report that they wish to and are capable of continuing their work. Change is needed to support enthusiastic young female doctors and students and enable them to maintain their skills and professional advancement during pregnancy.
Open Access
Passage- and serum-dependent changes of adipose-derived stromal cells in vitro: a discrepancy of stemness factors regarding mesenchymal surface markers and expression of stemness-related genes

2. Dezember 2024

Renata Sonnenfeld, Peter M. Vogt, Jörn W. Kuhbier, Sarah Strauss

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Objectives Autologous fat transplantation is a promising source for cell therapy and tissue engineering. However, the physiological function and regulatory mechanisms of in vitro cell culture remain largely unexplored. Furthermore, no standard protocol for cell culture of human adipose-derived stem cells (hASC) has been described. Previous studies have reported the impact of media supplementation on the loss of stemness capacity. Methods In this study, we compared the expression of stemness-defining surface markers according to the minimal criteria definition (CD 11b⁻, CD 31⁻, CD 34⁻, CD 45⁻, CD 73⁺, CD 90⁺, and CD 105⁻) by flow cytometry analysis with the expression of stemness-related genes such as MCAM, OCT4, MYC, and cKit in hASCs cultured in either fetal calf serum (FCS) or human serum (HS) supplemented medium from passage 0 to 5. Results As expected, we found that hASCs in both groups retained their typical mesenchymal surface marker profile CD 73 and CD 90 (>95 %) in flow cytometry analysis, as well as the absence of CD 11b, CD 31, CD 34, and CD 45 (<5 %) until passage 5. However, in contrast to that, RT-PCR indicated a passage-dependent decline and medium-dependent changes in the transcriptome, in particular the loss of the stemness-related genes cKit and MCAM in both groups, while MYC and OCT4 showed unpredictable expression. Conclusions Summarized, these results indicate the need for standardized cell culture protocol, as the transcriptome seems to change during in vitro cultivation, although an ASC-typical pattern of surface markers remains. In this regard, our study aims to contribute to the establishment of a standard protocol to achieve reliability, validity, and objectivity for future cell therapy or clinical applications.
Open Access
A cross-sectional survey of the safety attitudes questionnaire subscale stress recognition and the effect of non-technical skills training in operating theatre staff

20. November 2024

Sebastian Leuschner, Philipp Schenk, Carolin Gräbsch, Frank Siemers

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Objectives Non-technical skills (NTS) training of surgical staff is a quality improvement measure to improve patient safety. One factor that can compromise patient safety is impaired staff performance due to stressors such as tiredness. Awareness of the impact of such stressors is measured by the stress recognition (SR) domain of the Safety Attitudes Questionnaire (SAQ). The aim of this study was to assess whether NTS training improves SR scores and whether there are any groups with divergent SR scores. Methods A cross-sectional survey of all operating theatre staff in a German major trauma centre was undertaken using the stress recognition (SR) subscale of the SAQ. A multivariable linear regression was performed to assess which factors are associated with SR scores. Data are presented as median (interquartile range). Results From 226 invited staff members, 89 responses (39 %) were received. Twenty-eight respondents (31 %) had attended NTS training. The overall SR score was 4.3 (3.5–4.5). There was no effect of NTS training, age, gender, profession, or specialty on SR scores. Physicians in leadership positions had lower SR scores (3.4 (3.06–4.0)) than physicians without leadership positions (4.5 (4.3–5.0), p<0.001). Conclusions Attendance at NTS training courses did not improve SR scores in the clinical staff of operating theatres of a German major trauma centre. Interestingly, physicians in leadership positions had lower SR scores than other physicians. Further studies using the SAQ should discriminate between physicians in leadership positions and other physicians when reporting SR scores.
Open Access
Conventional partial pancreatoduodenectomy versus an uncinate first, extended partial pancreatoduodenectomy approach for the resection of pancreatic head cancer: the randomized, controlled PancER trial

26. August 2024

Patrick Heger, Markus K. Diener, Manuel Feißt, Matthias M. Gaida, Christina Klose, Phillip Knebel, Rosa Klotz, Colette Dörr-Harim, André L. Mihaljevic

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Objectives After pancreatoduodenectomy (PD) due to pancreatic cancer, recurrence is frequent in almost half of the patients. The rate of R0 resections is associated with the probability of local recurrence and overall survival. A potential intervention to improve the rate of R0 resections is a more radical resection along the superior mesenteric artery (SMA); however, randomized data of such an approach are lacking. Therefore, we conducted the randomized, controlled PancER trial to evaluate the effect of an extended PD compared with conventional PD. Methods Patients were randomized to either an extended PD consisting of a modified Kocher maneuver with partial resection of the prerenal fascia, an uncinate process first approach with systematic mesopancreatic dissection along the SMA equivalent to level III dissection according to Inoue, or conventional PD. The primary endpoint, rate of R0 resections, and other perioperative outcomes were compared. Results A total of 50 patients were randomly assigned to extended PD (n=24) or conventional PD (n=26). R0 resections were 10 % more frequent in the extended PD group than in the conventional group (75.0 vs. 64.7 %), which was not statistically significant (p=0.59). Patients self-reported more diarrhea symptoms following extended PD after 30 days (p<0.01). Other perioperative outcomes as well as long-term outcomes were comparable between the two groups. Conclusion The PancER trial shows that extended PD with more radical resection along the SMA can be performed with comparable perioperative outcomes to conventional PD. Although the intervention improved the R0 resection rate by 10 %, this increase was below expectation. Therefore, an even more radical PD resection technique involving not only the SMA but also the celiac and hepatic artery (TRIANGLE operation) was developed at Heidelberg University. The TRIANGLE operation is currently being evaluated in a randomized controlled multicenter trial. The results of the PancER trial served as pilot data for this subsequent study.
Open Access
Deep learning for automated boundary detection and segmentation in organ donation photography

20. August 2024

Georgios Kourounis, Ali Ahmed Elmahmudi, Brian Thomson, Robin Nandi, Samuel J. Tingle, Emily K. Glover, Emily Thompson, Balaji Mahendran, Chloe Connelly, Beth Gibson, Lucy Bates, Neil S. Sheerin, James Hunter, Hassan Ugail, Colin Wilson

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Objectives Medical photography is ubiquitous and plays an increasingly important role in the fields of medicine and surgery. Any assessment of these photographs by computer vision algorithms requires first that the area of interest can accurately be delineated from the background. We aimed to develop deep learning segmentation models for kidney and liver organ donation photographs where accurate automated segmentation has not yet been described. Methods Two novel deep learning models (Detectron2 and YoloV8) were developed using transfer learning and compared against existing tools for background removal (macBGRemoval, remBGisnet, remBGu2net). Anonymised photograph datasets comprised training/internal validation sets (821 kidney and 400 liver images) and external validation sets (203 kidney and 208 liver images). Each image had two segmentation labels: whole organ and clear view (parenchyma only). Intersection over Union (IoU) was the primary outcome, as the recommended metric for assessing segmentation performance. Results In whole kidney segmentation, Detectron2 and YoloV8 outperformed other models with internal validation IoU of 0.93 and 0.94, and external validation IoU of 0.92 and 0.94, respectively. Other methods – macBGRemoval, remBGisnet and remBGu2net – scored lower, with highest internal validation IoU at 0.54 and external validation at 0.59. Similar results were observed in liver segmentation, where Detectron2 and YoloV8 both showed internal validation IoU of 0.97 and external validation of 0.92 and 0.91, respectively. The other models showed a maximum internal validation and external validation IoU of 0.89 and 0.59 respectively. All image segmentation tasks with Detectron2 and YoloV8 completed within 0.13–1.5 s per image. Conclusions Accurate, rapid and automated image segmentation in the context of surgical photography is possible with open-source deep-learning software. These outperform existing methods and could impact the field of surgery, enabling similar advancements seen in other areas of medical computer vision.
Open Access
Right hepatectomy in absence of the left portal vein using the porto-rex shunt procedure

9. August 2024

Sven A. Lang, Jan Bednarsch, Sophia M. Schmitz, Marius J. Helmedag, Iakovos Amygdalos, Daniel Heise, Maxime Dewulf, Tom F. Ulmer, Ulf P. Neumann

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Objectives Exact knowledge of the portal vein (PV) anatomy is essential for any hepatobiliary procedure. Absence of the portal bifurcation with the complete blood flow to the left lobe coming from the right portal vein (RPV) is an extremely rare anatomical variation. Case presentation In this situation, a solitary metachronous colorectal liver metastasis with suspected infiltration of the RPV and the right bile duct was detected in a 51-year-old male patient. Neither percutaneous ablation nor stereotactic radiotherapy were considered indicated due to the close proximity to the central structures. Hence, a surgical two-step procedure was scheduled. First, a porto-rex shunt with an 8 mm PTFE graft to maintain the portal blood flow to the left lobe was performed. In addition, the RPV was ligated during the same procedure. After recovery, the procedure was completed with a right hepatectomy. The final pathological report confirmed invasion of the right bile duct and the RPV and resection margins were tumor-free. Conclusion This case shows that careful preoperative assessment of vascular anatomy is critical. The use of the porto-rex shunt allowed a potentially curative resection in an otherwise irresectable situation.
Open Access
Quality of outcome (QoO) in oral cancer patients: prospective perioperative analysis of patients’ resilience and satisfaction during inpatient stay at a University Medical Centre in Germany

2. August 2024

Juliane Kröplin, Jil-Charlot Reppenhagen, Anke Hirsemann, Jan Liese, Bernhard Frerich

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Objectives Quality assurance strategies for head and neck surgery can improve patient outcomes. This study aims a perioperative analysis of indicators in the quality of outcome in oral cancer patients with special focus on patient`s resilience and satisfaction before and after surgery. Methods Patients with oral cancer (OCP) and indication for surgical resection were included in a prospective study. General and disease-related data as well as parameters of patient-specific resilience (RS-11 questionnaire) and physical strength (ECOG-Score) were collected. Importance and satisfaction using the nine items family/friends, sports activities/physiotherapy, participation in culture, professional perspectives, sexuality, enjoyable food, external appearance, social recognition and independence were analysed. The data collection took place pre- and postoperatively (mean: 10th postop day) during the inpatient stay. Results Twenty-eight patients with oral cancer (OCP) were analysed (male: n=23, female n=5). The rate of R0 resections was 92.6 %. The average length of stay was 21 days. n=16 of all patients was tracheotomised postop (preop: n=0). n=0 patients confirmed psycho(onco)logical support preop (postop: n=19). Sports activities/physiotherapy was provided to n=3 patients preop (postop: n=21). The mean pre and postop pain perception was 3/10. The RS-11 score decreased significantly postoperatively (p=0.01). A significant loss of satisfaction was seen in the areas of enjoyable food (p<0.001), social recognition (p=0.01), external appearance (p=0.01) and independence (p<0.001). Conclusions Supportive therapy measures to promote mental and physical fitness of oral cancer patients are part of inpatient care at our clinic. However, there is no standardised monitoring of these therapies. Digitally supported and standardised programmes to increase mental and physical fitness in both prehospital and inpatient care might lead to an improvement in the quality of outcome despite shortage of resources in terms of time, costs and personnel. A minimally invasive approach to tracheal cannula management and lymph node management in the treatment of OCP can help to reduce the length of stay in the intensive care unit.

Abstracts – DCK 2025 – 142nd Congress of the German Society of Surgery

Abstracts – DCK 2024 – 141st Congress of the German Society of Surgery

Abstracts – DCK 2023 – 140th German Congress of Surgery

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Special Issue: Thyroid surgery

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Abstracts – DGCH Annual Congress 2022

Abstracts – DGCH Annual Congress 2021

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Abstracts - VBC Annual Congress 2020

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Abstracts – DGCH Annual Congress 2020

Abstracts – DGCH Annual Congress 2019

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SPECIAL ISSUE: Innovative Medical Technologies in Vascular Medicine / GUEST EDITORS: Markus Kleemann and Thorsten M. Buzug

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Highlight: Basic Research in Pediatric Surgery / Guest Editor: Peter P. Schmittenbecher und Jens Dingemann

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Abstracts – DGCH Annual Congress 2018

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Highlight: Colorectal Cancer - heading for the future / Guest Editor: Werner Hohenberger

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Highlight: Innovations in Plastic Surgery / Guest Editor: Peter M. Vogt

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Special Issue: Surgery 4.0 - Digitalization in Surgery / Guest Editor: Hubertus Feußner

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Highlight: Outcomes in inguinal hernia repair / Guest Editor: Ferdinand Köckerling

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Abstracts – DGCH Annual Congress 2017

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Highlight: Challenges in geriatric trauma care / Guest Editor: Tim Pohlemann

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Special features in oncologic surgery

Journal Impact Factor	1.2	2024, Journal Citation Reports (Clarivate, 2025)
5-year Journal Impact Factor	1.6	2024, Journal Citation Reports (Clarivate, 2025)
Journal Citation Indicator	0.55	2024, Journal Citation Reports (Clarivate, 2025)
CiteScore	2.1	2024, Scopus (Elsevier B.V., 2025)
SCImago Journal Rank	0.296	2024, SJR (Scimago Lab, 2025; Data Source: Scopus)
Source Normalized Impact per Paper	0.774	2024, CWTS Journal Indicators (CWTS B.V., 2025; Data Source: Scopus)

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Editor-in-Chief

Udo Rolle, Klinik für Kinderchirurgie und Kinderurologie, Universitätsklinikum Frankfurt am Main, Frankfurt am Main/Germany

Deputy Editor-in-Chief

Claudia Rudroff, Klinik für Allgemein- und Viszeralchirurgie, Department für Viszeralchirurgie und funktionelle Chirurgie des unteren Gastrointestinaltraktes, Evangelisches Klinikum Köln Weyertal, Akademisches Lehrkrankenhaus der Universitätsklinik Köln

National Editorial Board

Jens Werner, Medical Center of the University of Munich (LMU Klinikum), Munich/Germany;
Representative of the DGAV - German Society of General and Digestive Surgery
Barbara Ranther, Medical Center of the University of Munich (LMU Klinikum), Munich/Germany;
Representative of the DGG – German Society of Vascular Surgery
Ulrich Rother, University Medical Center Erlangen, Erlangen/Germany
Representative of the DGG – German Society of Vascular Surgery
Guido Seitz, University Medical Center Gießen and Marburg (UKGM), Marburg/Germany;
Representative of the DGKCH – German Society of Pediatric Surgery
Martin Gosau, University Medical Center Hamburg-Eppendorf (UKE), Hamburg/Germany;
Representative of the DGMKG – German Society of Oral and Maxillofacial Surgery
Erol Sandalcioglu, Universitätsklinik für Neurochirurgie, Universitätsklinikum Magdeburg A.ö.R., Magdeburg/Germany;
Representative of the DGNC – German Society of Neurosurgery
Christoph Lohmann, University Medical Center Magdeburg (OVGU/UKMD), Magdeburg/Germany;
Representative of the DGOOC - German Society of Orthopedics and Orthopedic Surgery
Justus Beier, University Medical Center Aachen (RWTH), Magdeburg/Germany;
Representative of the DGPRÄC – German Society of Plastic, Reconstructive and Aesthetic Surgery
Tobias Hirsch, Specialist clinic Hornheide, Münster/Germany;
Representative of the DGPRÄC – German Society of Plastic, Reconstructive and Aesthetic Surgery
Severin Schmidt, University Medical Center Freiburg, Freiburg/Germany;
Representative of the DGT – German Society of Thoracic Surgery
Frank Hildebrand, University Medical Center Aachen (RWTH), Magdeburg/Germany;
Representative of the DGU – German Society of Trauma Surgery

Executive Editors

Adam Dziki, Department of General and Colorectal Surgery, Medical University Łódź, Łódź/Poland
Karl-Walter Jauch, Department of Surgery, Medical Center of the University of Munich, Munich/Germany
Martin S. Karpeh, Department of Surgery, Hackensack University Medical Center, Hackensack/USA
Masaki Kitajima, Surgery and Digestive Disease Center, International University of Health and Welfare, Tokyo/Japan
Paul Mansfield, Department of Surgical Oncology, The University of Texas, Monroe Dunaway Anderson Cancer, Houston/USA
Tim Pohlemann, Department of Trauma, Hand and Reconstructive Surgery, Saarland University Medical Center and Saarland University Medical Faculty, Homburg/Germany
John Primrose, Faculty of Medicine University of Southampton, Southampton General Hospital, Southampton/UK
Han-Kwang Yang, Department of Surgery, Seoul National University College of Medicine, Seoul/Korea

Advisory Board - German Society of General and Digestive Surgery

Associate Editor

Matthias Anthuber, Department of General, Visceral, and Transplantation Surgery, Augsburg Medical Center, Augsburg/Germany
Heinz-Johannes Buhr, German Society of General and Visceral Surgery, Berlin/Germany
Alberto Ferreres, Department of Surgery, University of Buenos Aires, Buenos Aires/Argentina
Christoph Germer, Medical Faculty, University of Wuerzburg, Wuerzburg/Germany
Claus Dieter Heidecke, Clinic of General, Visceral, Thoracic and Vascular Surgery, University Medicine Greifswald, Greifswald/Germany & Institute for Quality Assurance and Transparency in Health Care (IQTIG), Berlin/Germany
Ernst Klar, Department of General, Thoracic, Vascular and Transplantation Surgery, Rostock University Hospital, Rostock/Germany
Dietmar Lorenz, Department of General and Visceral Surgery, Sana Hospital, Offenbach/Germany
Hauke Lang, Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz/Germany
Johann Pratschke, Department of General, Visceral, and Transplantation Surgery, Charité – Univeristy Medicine Berlin, Berlin/Germany
Raul Rosenthal, The Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston/USA
Albrecht Stier, Department of General and Visceral Surgery, Helios Hospital Erfurt, Erfurt/Germany
Steven D. Wexner, Department of Colorectal Surgery, Cleveland Clinic Florida, Weston/USA

Co-Editor

Werner Hartwig, Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Medical Center of the University of Munich, Munich/Germany
Beate Rau, Department of General, Visceral, Thoracic and Vascular, Charité – Univeristy Medicine Berlin, Berlin/Germany
Peter Schemmer, Department of Transplant Surgery, University Hospital Graz, Graz/Austria
Maria Barbara Witte, Department of General, Thoracic, Vascular and Transplantation Surgery, University Medicine Rostock, Rostock/Germany

Advisory Board - German Society of Vascular Surgery

Associate Editor

Sebastian Debus, Department of Vascular Medicine, University Heart Center, University Hospital Hamburg-Eppendorf, Hamburg/Germany
Thomas Schmitz-Rixen, Department of Vascular and Endovascular Surgery, University Hospital Johann Wolfgang Goethe Frankfurt, Frankfurt am Main/Germany
Giovanni Torsello, Department of Vascular Surgery, St. Franziskus Hospital, Muenster/Germany

Co-Editor

Theodosios Bisdas, Department of Vascular Surgery, St. Franziskus Hospital, Muenster/Germany

Advisory Board - German Society of Pediatric Surgery

Associate Editor

Guido Fitze, Department of Pediatric Surgery, University Hospital Carl Gustav Carus, Dresden/Germany
Jörg Fuchs, Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tübingen, Tübingen/Germany
Martin Lacher, Department of Pediatric Surgery, University Hospital Leipzig, Leipzig/Germany
Oliver Muensterer, Department of Pediatric Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz/Germany
Udo Rolle, Department of Pediatric Surgery and Pediatric Urology, University Hospital Frankfurt, Frankfurt am Main/Germany
Paul KH Tam, Department of Paediatric Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong/China

Co-Editor

Michael F. Berger, Department of Pediatric Surgery, Dr. von Hauner Children's Hospital, Ludwig Maximilian University, Munich/Germany
Jens Dingemann, Center of Pediatric Surgery, Hannover Medical School, Hannover/Germany

Advisory Board - German Society of Oral and Maxillofacial Surgery

Associate Editor

Daniel Buchbinder, Department of Oral and Maxillofacial Surgery and Otolaryngology, Mount Sinai-Beth Israel Medical Center, New York/USA
David A. Mitchell, Department of Maxillofacial Surgery, Bradford Teaching Hospitals NHS Foundation Trust, Bradford/UK /LI>
Henning Schliephake, Department of Oral and Maxillofacial Surgery, University Medical Centre Goettingen, Goettingen/Germany

Co-Editor

Thomas Mücke, Department of Oral and Cranio-Maxillofacial Surgery, University Hospital Klinikum rechts der Isar Munich, Munich/Germany
Urs Müller-Richter, Department of Oral and Maxillofacial Plastic Surgery, University Hospital of Wuerzburg, Wuerzburg/Germany
Sven Otto, Department of Oral and Maxillofacial Surgery, Medical Center of the University of Munich, Munich/Germany

Advisory Board - German Society of Neurosurgery

Associate Editor

Gabriele Schackert, Department of Neurosurgery, University Hospital Carl Gustav Carus, Dresden/Germany
Volker Seifert, Center of Clinical Neurosciences, University Hospital of Frankfurt, Frankfurt am Main/Germany
Ulrich Sure, Department of Neurosurgery, University Hospital of Essen, Essen/Germany

Advisory Board - German Society of Orthopedics and Orthopedic Surgery

Associate Editor

Tilman Calliess, Christenortho AG, Bern/Switzerland
Klaus-Peter Günther, Center for Orthopaedic and Trauma Surgery, University Hospital Carl Gustav Carus, Dresden/Germany
Bernd Kladny, m&i Specialised Hospital, Herzogenauchrach/Germany
Henning Windhagen, Department of Orthopedic Surgery, Diakovere Annastift, Hannover/Germany
Luigi Zagra, Hip Department, Galeazzi Orthopaedic Institute IRCCS, Milan/Italy

Advisory Board - German Society of Plastic, Reconstructive and Aesthetic Surgery

Associate Editor

Eva Maria Baur, Practice for Plastic Surgery and Hand Surgery, Murnau/Germany
Hisham Fansa, Department Plastic Surgery, Hospital Zollikerberg & BrustCentrum Zurich, Bethanien & Zollikerberg, Switzerland
Pietro Giovanoli, Department of Plastic Surgery and Hand Surgery, University Hospital of Zurich, Zurich/Switzerland
Raymund Horch, Department of Plastic and Hand Surgery, University Hospital of Erlangen, Erlangen/Germany
Lukas Prantl, Department of Plastic and Reconstructive Surgery, University Hospital Regensburg, Regensburg/Germany
Jiaming Sun, Department of Plastic and Aesthetic Hospital, Wuhan Union Hospital, Wuhan/China
Luc Téot, Wound Healing Unit, Montpellier University Hospital, Montpellier/France

Co-Editor

Holger Bannasch, Department of Plastic and Hand Surgery, University Medical Center Freiburg , Freiburg/Germany
Thomas Kremer, Department of Plastic and Hand Surgery, Klinikum St. Georg, Leipzig/Germany
Thilo Schenck, Department of Plastic Surgery and Hand Surgery, University Hopital Klinikum rechts der Isar Munich, Munich/Germany

Advisory Board - German Society of Thoracic Surgery

Associate Editor

Joachim Pfannschmidt, Department of Thoracic Surgery, HELIOS Clinic Emil von Behring, Berlin/Germany
Freyja-Maria Smolle-Jüttner, Department of Surgery, Medical University of Graz, Graz/Austria

Advisory Board - German Society of Thoracic and Cardiovascular Surgery

Associate Editor

Kwabena Frimpong-Boateng, National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra/Ghana
Axel Haverich, Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover/Germany
Christian-Friedrich Vahl, Department of Cardiothoracic and Vascular Surgery, University Medical Center Mainz, Mainz/Germany

Co-Editor

Lars Conzelmann, Department of Cardiac Surgery, HELIOS Clinic, Karlsruhe/Germany

Advisory Board - German Society of Trauma Surgery

Associate Editor

Florian Gebhard, Department of Trauma, Hand and Reconstructive Surgery, Ulm University Medical Center, Ulm/Germany
Paul Alfred Grützner, Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen/Rhine, Ludwigshafen/Germany
Reinhard Hoffmann, Department of Trauma and Orthopedic Surgery, BG Trauma Center Frankfurt am Main, Frankfurt am Main/Germany
Christoph Josten, Department of Orthopaedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig/Germany
Christian Krettek, Department of Trauma, Hannover Medical School, Hannover/Germany
Luke Leenen, Department of Trauma, University Medical Centre Utrecht, Utrecht/Netherlands
Olivera Lupescu, Clinical Emergency Hospital, University of Medicine and Pharmacy, Bucharest/Romania
Ingo Marzi, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Frankfurt am Main/Germany
Theodore Miclau, Department of Orthopedic Surgery, University of California San Francisco Medical Center, San Fransisco/USA
Fabian Stuby, Department of General and Trauma Surgery, BGU Clinic Murnau, Murnau/Germany
Joachim Windolf, Department of Trauma and Hand Surgery, Medical Faculty, University Hospital Duesseldorf, Duesseldorf/Germany

Co-Editor

Tina Histing, Department of Trauma and Reconstructive Surgery, BG Clinic Tuebingen, Tuebingen/Germany
Sebastian Wutzler, Department of Trauma, Hand and Orthopedic Surgery Clinic, Helios Dr. Horst Schmidt Clinics Wiesbaden, Wiesbaden/Germany

Advisory Board - Section Surgial Research of the German Society of Surgery

Associate Editors

Christiane Bruns, Department of General-, Visceral Surgery and Surgical Oncology, University Hospital Cologne, Cologne/Germany
Martijn van Griensven, Department of Experimental Trauma Surgery, University Hospital Klinikum rechts der Isar Munich, Munich/Germany
Matthias Laschke, Institute for Clinical and Experimental Surgery, Saarland University Medical Center and Saarland University Medical Faculty, Homburg/Germany
Brigitte Vollmar, Institute for Experimental Surgery, Rostock University Medical Center, Rostock/Germany

Advisory Board - Working Groups of German Society of Surgery

Associate Editors

Stephan Freys, Intestinal cancer center, DIAKO Clinical Center Bremen, Bremen/Germany
Heinz-Jochen Gassel, Department of Surgery, Protestant Hospital, Mülheim an der Ruhr/Germany
Stephan Kersting, Department of General and Vascular Surgery, University Hospital of Erlangen, Erlangen/Germany
Markus Kleemann, Department of Surgery, University Medical Center Schleswig-Holstein, Luebeck/Germany
Henning Mothes, Department of General, Visceral and Vascular Surgery, University Hospital Jena, Jena/Germany

Advisory Board - Additional Associate Editors

Hartmut Bürkle, Department of Anesthesiology and Critical Care, University Medical Center Freiburg, Freiburg/Germany
Roland Croner, Department of General, Visceral and Vascular Surgery, University Clinic Magdeburg, Magdeburg/Germany
Markus K. Diener, Department of General and Visceral Surgery, University Medical Center Freiburg, Freiburg/Germany
Dominique Franco, Department Hepatinov, University of Paris-Sud, Paris/France
Ines Gockel, Department of Visceral Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig/Germany
Norbert Haas, Managing Director of the Langenbeck-Virchow-Haus on the part of the German Society of Surgery, Berlin/Germany
Jakob Izbicki, Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg/Germany
Ferdinand Köckerling, Department of Surgery and Center for Minimally Invasive Surgery, Charité – Univeristy Medicine Berlin, Berlin/Germany
Hans Lippert, em., University Clinic Magdeburg, Magdeburg/Germany
Florian Lordick, University Cancer Center Leipzig , University Hospital Leipzig, Leipzig/Germany
Kaja Ludwig, Clinic of General, Visceral, and Thoracic Surgery, Medical Center Suedstadt, Rostock/Germany
Hans-Joachim Meyer, German Society of Surgery, Berlin/Germany
Aviram Nissan, Department of General and Oncological Surgery, The Chaim Sheba Medical Center, Tel Hashomer, Israel
Karl Oldhafer, Department of General, Visceral and Oncological Surgery, Asklepios Clinic Barmbek, Hamburg/Germany
Pompiliu Piso, Department of General and Visceral Surgery, Hospital of the Order of St.John of God Regensburg, Regensburg/Germany
Hans Detlev Saeger, em., University Hospital Carl Gustav Carus, Dresden/Germany
Eduardo de Santibanes, Department of General Surgery, Italian Hospital of Buenos Aires, Buenos Aires/Argentina
Thomas Schiedeck, Department of General and Visceral Surgery, Clinical Centre Ludwigsburg, Ludwigsburg/Germany
Klaus-Martin Schulte, Professor and Chair of Surgery, College of Medicine, Biology and Environment, Australian National University, Garran/Australia
Albert Tuchmann, Secretary General, Austrian Society for Surgery, Vienna/Austria
Alexis Ulrich, Clinic of General, Visceral, Thoracic and Vascular Surgery, Lucas Clinic Neuss, Neuss/Germany
Benno Ure, Department of Pediatric Surgery, Medical School of Hannover, Hannover/Germany
Peter Vogt, Department of Plastic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover/Germany
Grzegorz Wallner, II Chair and Department of General and Gastrointestinal Surgery and Surgical Oncology of the Alimentary Tract, Medical University of Lublin, Lublin/Poland
Jürgen Weitz, Department of Surgery, University Hospital Dresden, Dresden/Germany

Advisory Board - Additional Co-Editors

Güralp Onur Ceyhan, Department of General Surgery, Acıbadem Healthcare Group, Istanbul/Turkey
Marc-Hendrik Dahlke, Department of General and Visceral Surgery, Robert-Bosch-Clinic, Stuttgart/Germany
Hubertus Feußner, Department of Surgery, Technical University of Munich, University Hospital Klinikum rechts der Isar, Munich/Germany
Stefan Fichtner-Feigl, Department of General and Visceral Surgery, University Medical Center Freiburg, Freiburg/Germany
Felix Hüttner, Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg/Germany
Andreas Kirschniak, Department of General and Visceral Surgery, Clinics Maria Hilf, Moenchengladbach/Germany
Ulla Klaiber, University Hospital for General Surgery, Medical University of Vienna, Vienna/Austria
Sven Arke Lang, Clinic for Visceral, General and Transplant Surgery, University Clinic RWTH Aachen, Aachen /Germany
Hanno Matthaei, Department of Surgery, University Hospital of Bonn Center for Integrated Oncology (CIO) Cologne-Bonn, Bonn/Germany
Sören Torge Mees, Department of General, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Dresden/Germany
Christoph Michalski, Department of General and Visceral Surgery, Ulm University Medical Center, Ulm/Germany
Stefan Mönig, Department of Visceral Surgery, University Hospital Geneva, Geneva/Switzerland
Marco Niedergethmann, Department of General and Visceral Surgery, Alfried Krupp Hospital, Essen/Germany
Pascal Probst, Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Study Center of the German Surgical Society (SDGC), Heidelberg/Germany
Falk Rauchfuß, Department of General, Visceral and Vascular Surgery, University Hospital Jena, Jena/Germany
Thomas Schmidt, Department of General, Visceral, Tumor and Transplantation Surgery, University Hospital Cologne, Cologne/Germany
Martin Schneider, Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg/Germany
Andreas Schnitzbauer, Department of General and Visceral Surgery, University Hospital Frankfurt, Frankfurt am Main/Germany
Dierk Schreiter, Department of Cardiac Surgery, Helios Hospital Leipzig, Leipzig/Germany
Wolfgang Schröder, Department of General, Visceral and Cancer Surgery, University Hospital Cologne, Cologne/Germany
Thilo Sprenger, Department of General Surgery, UKGM University Hospital Giessen, Giessen/Germany
Oliver Strobel, Department of General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg/Germany
Daniel Vallböhmer, Department of Surgery, Evangelical Hospital Niederrhein, Duisburg/Germany
Tim Vilz, Department of Surgery, University Hospital Bonn, Bonn/Germany
Jens Waldmann, Department of General and Endocrine Surgery, MIVENDO Clinic Hamburg, Hamburg/Germany
Ulrich Wellner, Clinic for Surgery, University Medical Center Schleswig-Holstein, Luebeck/Germany
Moritz Wente, Health Association of the District of Constance (GLKN), Singen/Germany

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Medizin Klinische Medizin Chirurgie Chirurgie, andere

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eISSN:

2364-7485

Sprache:

Englisch

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De Gruyter

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Erstveröffentlichung:

1. März 2016

Erscheinungsweise:

4 Hefte pro Jahr

eISSN: 2364-7485

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basic scientists, translational researchers, clinical researchers, industry scientists and professionals in the field of surgery

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