Robot-assisted minimal access surgery (MAS), compared with conventional MAS, has shown a number of benefits across several therapeutic indications but its use for transthoracic esophagectomy (TTE) requires further evaluation. Here, we report the first-in-human series of major esophageal resections performed using a next-generation tele-operated robotic surgical system in a single center. Robot-assisted TTE was performed using the Versius Surgical System by a single surgeon to assess the robotic system’s ability to achieve tumor clearance (measured by R0 resection rates) whilst reducing anastomotic leakage rates. Intra- and post-operative outcomes such as median operative time, length of hospitalization, intra-operative blood loss, and the number of complications were also assessed. Fifty-seven patients underwent robot-assisted TTE between August 2019 and June 2021. All procedures were completed successfully with no unplanned conversions to alternative surgical methods. Estimated blood loss was minimal, and no adverse events, complications or deaths were reported. Our experience with the Versius Surgical System demonstrates its safe adoption and implementation for TTE.

We describe a new species of the Hemidactylus acanthopholis clade from Sirumalai, an isolated massif in the Dindigul district of Tamil Nadu state, India. Hemidactylus sirumalaiensis sp. nov. can be diagnosed from all members of the prashadi group by its medium body size (SVL <95 mm), the number of dorsal tubercles rows at mid-body, the number of enlarged tubercles in paravertebral rows, the number of femoral pores and poreless scales between series of left and right femoral pores on the femoral-precloacal row in males, the number of ventral scales across the belly at mid-body and subtle colour pattern differences. The new species is the fourth member of the acanthopholis clade and 8.5–13.4 % divergent in ND2 sequence data from other members of the clade. We also provide data on additional specimens from a new locality of Hemidactylus kolliensis, previously known only from the male holotype. Hemidactylus sirumalaiensis sp. nov. is the first endemic and only the other vertebrate species described from Sirumalai massif in the last 133 years. Most rupicolous Hemidactylus species from peninsular India outside the Western Ghats are known only from a few localities and are likely to be geographically restricted in distribution, and large areas of suitable habitat remain unsurveyed, suggesting many more allied species remain to be discovered.

Introduction: Endodontic access cavity preparation plays a vital role as preservation of enamel structure is of utmost importance for a tooth's strength to be maintained. As teeth become fragile after a root canal therapy, this study was designed to compare in vitro the fracture resistance of root-filled and restored teeth with traditional endodontic access cavity, conservative endodontic access cavity (CEC), ninja endodontic access cavity (NEC), and truss endodontic access cavity (TEC).Materials and methods: Control (intact teeth) and traditional endodontic access cavity as well as CEC, NEC, and TEC groups were each given a new human mandibular molar that was freshly removed. Cone beam computed tomography (CBCT) scans of the cone beam showed the values of CEC, NEC, and TEC. After that the teeth were endodontically treated and repaired. To test the specimens, universal testing equipment was used. In order to avoid tooth breakage, the maximum load was determined. Statistical analysis was used in the form of Kolmogorov-Smirnov and Levene tests, which were used to examine data for typical dispersion and consistency in change.Results: Intact teeth showed the highest resistance to fracture compared with other groups. TEC showed significantly higher resistance to fracture compared to the CEC design.Conclusions: It is possible, within the restrictions of this research, to infer that the TEC design enhanced tooth fracture strength in comparison with the CEC design.

Aesthetic dentistry continues to evolve via advances in bonding agents, restorative materials, and conservative preparation methods. Alternatives to dental amalgam and gold include ceramic dental restorative materials. The lifespan of ceramic inlay repairs is still up for debate. When it comes to durability, colour matching, and anatomical shape stability, ceramic inlay restorations top the list of options. More predictable long-term performance may be achieved by strategically placing ceramic inlays in teeth that are not subjected to significant occlusal stress. Preparation design for ceramic inlay materials is necessary to avoid flexure. This case report discusses the ceramic inlay practice for functional and aesthetic restoration in a patient.

No abstract