The Modern Mosaic of War Trauma Surgery in Iran - Dr Reza Lankarani
Wednesday, June 10, 2026
Friday, May 22, 2026
Thursday, December 11, 2025
How the Menopause Scandal Affected Millions of Women
By Dr Reza Lankarani, General Surgeon
Founder | Surgical Pioneering Newsletter and Podcast Series
Editorial Board Member | Genesis Journal of Surgery and Medicine
The Menopause Scandal That Affects Millions is a shocking revelation that sheds light on the often misunderstood and stigmatized topic of menopause. As women's health continues to be a pressing concern, it is essential to address the menopause scandal that affects millions of women worldwide. Menopause awareness is crucial, and it is high time we break down menopause myths and delve into the symptoms explained by medical experts. Hormone therapy, including hormone replacement therapy, is a common solution for women experiencing night sweats, hot flashes, and hormonal imbalance. However, the menopause scandal highlights the need for better menopause support and education, not just for women but also from a men's perspective. Understanding what is menopause, its causes, and what causes hot flashes is vital in providing adequate menopause solutions. The menopause journey can be challenging, but with the right approach to menopause issues, women can find relief from symptoms of menopause. This video aims to spark a conversation about the menopause scandal, promoting menopause awareness and providing valuable insights into women's health, particularly in the context of perimenopause and hormone therapy. By exploring the complexities of menopause, we hope to empower women with the knowledge they need to take control of their health and well-being.
To access additional details, please refer to the Surgical Pioneering Podcast Series application available at the following link:
https://Surgicalpioneer.codeadx.me
https://lankarani.substack.com/p/menopause-care-regulatory-issues?utm_source=youtube
Sunday, December 7, 2025
LIVERATION آینده جراحی سرطان کبد به روش
Reviewed by Dr Reza Lankarani, General Surgeon
Founder | Surgical Pioneering Newsletter and Podcast Series
Editorial Board Member | Genesis Journal of Surgery and Medicine
- Published online: 13 October 2025
- Citation: Luque Villalobos E et al. BMJ Open 2025;15:e100518.
1. Overview
The LIVERATION trial is a prospective, international, multicentre, single-blind, parallel-group, randomised clinical trial (RCT) funded by the Horizon Europe Programme (Grant 101104360). It aims to determine whether additional margin coagulation (AMC)—using approved radiofrequency (RF) devices (e.g., Coolingbis®, Aquamantys®)—reduces local recurrence (LR) after liver resection for colorectal liver metastases (CRLM) and hepatocellular carcinoma (HCC).
- Design: 1:1 randomisation across 24 centres in 7 European countries.
- Sample size: 698 patients (518 CRLM, 180 HCC), powered to detect absolute reductions in LR of 6.9% (CRLM: 10.2% → 3.3%) and 15.5% (HCC: 20% → 4.5%).
- Primary endpoint: Incidence of LR within 3 years, centrally reviewed on standardized imaging.
- Secondary endpoints: Overall survival (OS), disease-free survival (DFS), cancer-specific survival, complications (Clavien-Dindo/CCI), and quality of life (EORTC QLQ-C30/HCC18).
- Follow-up: 30/90 days, then annually up to 3 years.
- Trial registration: NCT05492136.
The trial builds on earlier retrospective work by the same group, notably Villamonte et al. (2022) , which reported reduced LR with AMC, and Quesada et al. (2017) and Sui et al. (2019) , showing promising signals for RF-assisted transection and Aquamantys®, respectively.
To access additional details, please refer to the Surgical Pioneering Podcast Series application available at the following link:
https://Surgicalpioneer.codeadx.me
Monday, December 1, 2025
Surgical Pioneering Podcast | SynerFuse ULE: Pioneering the Future of Spine Surgery
It's based on review by;
Dr Reza Lankarani , General Surgeon
Founder | Surgical Pioneering Newsletter and Podcast Series
Editorial Board Member | Genesis Journal of Surgery and Medicine
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1. Introduction: A Leader in Modern Neurosurgery
With a distinguished career spanning 11 to 20 years since earning his medical degree from the University of Chicago's Pritzker School of Medicine, Dr. Rohan Lall has leveraged his extensive clinical expertise to address fundamental challenges in spine surgery. He is affiliated with M Health Fairview University of Minnesota Medical Center and M Health Fairview Southdale Hospital, and holds the strategic leadership role of Chief Medical Officer at SynerFuse, the company developing the innovative procedure bearing its name.
Core Areas of Expertise
• Robotic and Minimally Invasive Surgery
• Complex Spinal Surgery (including conditions like spinal fusion, stenosis, and spondylosis)
• Brain and Spinal Tumor Surgery
• Skull Base and Pituitary Tumor Surgery
Beyond his exceptional clinical skills, Dr. Lall is an innovator who is actively involved in the development of new technologies, most notably his groundbreaking work on a new procedure to treat chronic back pain.
2. The SynerFuse Innovation: A New Hope for Chronic Back Pain
🌟 Overview of the SynerFuse ULE™ Procedure
The SynerFuse ULE™ (Ultra Low Energy) Therapy is an innovative, integrated surgical approach designed to treat chronic low back and leg pain, which is often unaddressed by traditional spinal fusion alone.
Integrated Solution: The patented procedure, formally known as Electric Transforaminal Lumbar Interbody Fusion™ (e-TLIF™), combines two treatments into a single surgery:
Spinal Fusion (e.g., TLIF): To decompress, stabilize, and reconstruct the spine.
Neuromodulation (Direct Nerve Stimulation): To address residual neuropathic pain by altering how the nerve perceives pain.
How it Works: During the spinal fusion surgery, the surgeon implants the fusion hardware and, in the same single incision, places multi-channel electrical leads onto the affected nerves (specifically targeting the Dorsal Root Ganglion - DRG, in some cases). These leads are connected to an implantable pulse generator (NeuroFuse® System).
Goal: The primary goal is to provide preemptive, non-narcotic pain management immediately following spinal fusion, aiming to reduce chronic neuropathic pain and the need for long-term opioid use. Neuropathic pain can occur in up to 40-50% of patients after traditional spinal fusion, even if the fusion is successful.
Dr. Rohan Lall's Role: Dr. Rohan Lall, a neurosurgeon, has been a key figure in the proof-of-concept study for this procedure at M Health Fairview/University of Minnesota, performing one of the first solo SynerFuse implants in a two-level spinal fusion patient.
Current Status: The procedure has completed an initial proof-of-concept study to evaluate its safety and feasibility. The company is now designing and building the NeuroFuse® System in preparation for a larger pivotal clinical trial toward FDA approval.
A significant challenge in spinal surgery is the chronic low back and leg pain that can persist even after a successful spinal fusion procedure. The SynerFuse procedure was developed to address this very problem, offering a new approach for patients whose discomfort continues after traditional surgeries.
2.1. A Dual-Action Approach
The SynerFuse® e-TLIF™ procedure, a form of Ultra Low Energy (ULE™) Therapy, is an innovative technique that combines two powerful therapies into a single, integrated treatment: conventional spinal fusion surgery and targeted nerve stimulation (a practice known as neuromodulation). The goal is to address pain at its source by fundamentally altering the nerve’s ability to transmit pain signals to the brain.
2.2. Dr. Lall's Pioneering Role
Dr. Lall has been central to the development and implementation of this new technology. His specific contributions are a testament to his leadership in the field:
1. Served as an investigator for the SynerFuse Proof of Concept trial.
2. Pioneered the e-TLIF procedure.
3. Performed the world’s first solo SynerFuse e-TLIF procedure.
4. Completed the first-ever 2-level procedure.
2.3. Patient Impact and Future Outlook
This procedure represents a significant advancement in patient-centric care, although it is still in its early stages of evaluation.
Patient Benefits & Experience
Current Status & Outlook
Smartphone Control: Patients can control nerve stimulation.
Promising Initial Results: Early data shows significant benefit.
Significant Pain Reduction: Reported by early trial participants.
Limited Study Group: The procedure has been performed on a limited number of patients.
Improved Quality of Life without Opioid Dependence.
Long-Term Evaluation: Long-term effectiveness is still being actively studied.
This pioneering procedure exemplifies Dr. Lall's commitment to advancing the standards of spinal care by directly addressing the limitations of existing treatments.
3. Conclusion: An Innovator Shaping Spinal Care
Dr. Rohan Lall stands out not only as a highly skilled neurosurgeon but also as a forward-thinking leader shaping the future of his specialty. His active involvement in developing new technologies, particularly the SynerFuse procedure, marks a "significant step forward" in addressing the debilitating challenge of chronic back pain. Dr. Lall's inspiring dedication to enhancing patient health through innovative surgical solutions continues to push the boundaries of what is possible in spinal care.
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Dr Reza Lankarani , General Surgeon
Founder | Surgical Pioneering Newsletter and Podcast Series
Editorial Board Member | Genesis Journal of Surgery and Medicine
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To access additional details, please refer to the Surgical Pioneering Podcast Series application available at the following link:
https://Surgicalpioneer.codeadx.me
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Thursday, November 6, 2025
اهمیت زمانبندی صحیح بررسی ctDNA پس از درمان - How Long Until Cancer Comes Back
اهمیت زمانبندی صحیح بررسی ctDNA پس از درمان - How Long Until Cancer Comes Back
دکتر رضا لنکرانی | پادکست پیشگامان جراحی
By Dr Reza Lankarani, General Surgeon
Founder | Surgical Pioneering Newsletter and Podcast Series
Editorial Board Member | Genesis Journal of Surgery and Medicine
https://Surgicalpioneer.codeadx.me
Wednesday, November 5, 2025
Prehabilitation on Postoperative Outcomes #surgicalpioneering #rezala...
#surgery recovery #prehabilitation #surgery #surgery preparation #surgical recovery #surgery success #patient empowerment #pain management #recovery techniques #health optimization #surgical preparation #surgical techniques #patient recovery #preoperative care #enhanced recovery #physiotherapy #physical therapy #wellness strategy #injury prevention #surgical prep #rehabilitation tips #prehab #health coach #surgery strategies #patient preparation #recovery tips
Tuesday, October 14, 2025
Total Thymectomy Is Oncologically Superior to Partial Thymectomy in Patients with Thymic Carcinoma
Thymic Carcinoma
Reviewed by Dr Reza Lankarani, General Surgeon
Founder | Surgical Pioneering Newsletter and Podcast Series
Editorial Board Member | Genesis Journal of Surgery and Medicine
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International Journal of Surgery
October 15, 2025
DOI: 10.1097/JS9.0000000000003600
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1. Overview:
The study investigates whether partial thymectomy is oncologically acceptable for thymic carcinoma, a rare and aggressive subtype of thymic epithelial tumors (TETs). Using real-world multicenter data from 19 Japanese institutions (2010–2021), the authors analyzed 92 patients who underwent curative-intent resection—73 with total thymectomy and 19 with partial thymectomy.
Key Methods:
- Retrospective comparative cohort design.
- Primary endpoints: overall survival (OS) and recurrence-free survival (RFS).
- Statistical adjustment via overlap weighting to mitigate selection bias.
- Central pathological review for diagnostic consistency.
Key Findings:
- 79.3% of clinical stage I cases were upstaged postoperatively, highlighting limitations of preoperative imaging.
- In unadjusted analyses, partial thymectomy showed a trend toward worse OS and RFS (p ≈ 0.055–0.057).
- After propensity-weighted adjustment, partial thymectomy was significantly associated with:
- Worse OS (p = 0.0027)
- Higher recurrence risk (p < 0.0001), especially early postoperative recurrence.
- Local and distant recurrences were significantly more common in the partial group after weighting.
Conclusion:
Total thymectomy is oncologically superior for thymic carcinoma. Given the difficulty in preoperative differentiation from thymoma, total thymectomy should remain the standard for all resectable TETs unless a definitive benign diagnosis is confirmed.
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2. Critical Assessment: Strengths and Weaknesses
Strengths:
- Multicenter real-world data: Enhances generalizability beyond single-institution bias.
- Central pathological review: Ensures diagnostic uniformity—critical given histological complexity of TETs.
- Advanced statistical methodology: Use of overlap weighting (superior to traditional propensity matching in preserving sample size and reducing variance) effectively balances baseline imbalances (e.g., age, stage, performance status).
- Clinically relevant question: Addresses a growing dilemma as minimally invasive partial resections gain popularity for early thymoma.
- Clear staging discrepancy demonstration: The Sankey diagram powerfully illustrates the high rate of understaging in clinical practice.
Weaknesses:
- Small sample size in partial group (n=19): Limits statistical power for subgroup analyses and increases vulnerability to outliers.
- Retrospective design: Inherent selection bias—partial thymectomy patients were older, frailer, and had smaller tumors, suggesting surgeon preference for less aggressive surgery in higher-risk patients.
- Lack of standardized partial resection definition: “Partial” included hemi-thymectomy and tumor-only resection, introducing heterogeneity.
- No intraoperative frozen section use: While realistic (as noted in discussion), this reflects a missed opportunity to explore adaptive surgical strategies.
- Limited external validation: All centers are in Japan; biological or practice-pattern differences may limit global applicability.
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3. Comparison with Recent Studies
Recent literature largely supports partial thymectomy for early-stage thymoma but remains cautious for thymic carcinoma.
Graphical Insight (Conceptual):
Key Contribution:
This is among the first robust multicenter studies to demonstrate that partial thymectomy is inadequate for thymic carcinoma, even when tumors appear early-stage. It cautions against extrapolating thymoma data to carcinoma.
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Academic Significance:
This study makes a timely and clinically vital contribution. As minimally invasive surgery expands, there is a real risk of undertreating thymic carcinoma due to preoperative misclassification. The authors provide strong real-world evidence that total thymectomy is non-negotiable for optimal oncologic control in carcinoma.
Impact:
- Likely to influence guidelines (e.g., NCCN, ITMIG) to explicitly discourage partial resection when carcinoma cannot be ruled out.
- Reinforces the need for caution in adopting partial thymectomy outside rigorously confirmed early thymoma.
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Plain-Language Summary for Patients and the Public
If a tumor is found in the thymus (a small organ behind the breastbone), doctors often can’t tell before surgery whether it’s a slow-growing type (thymoma) or a more aggressive cancer (thymic carcinoma).
Some surgeons have started doing smaller operations (partial thymectomy) for what looks like early, harmless tumors. But this study shows that if the tumor turns out to be thymic carcinoma, the smaller surgery leads to more recurrences and lower survival.
Because it’s so hard to tell the difference before surgery, removing the entire thymus (total thymectomy) gives the best chance of curing the cancer, even if the tumor looks small and harmless on scans.
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Reviewed by Dr Reza Lankarani, General Surgeon
Founder | Surgical Pioneering Newsletter and Podcast Series
Editorial Board Member | Genesis Journal of Surgery and Medicine
To access additional details, please refer to the Surgical Pioneering Podcast Series application available at the following link:
https://Surgicalpioneer.codeadx.me
Sunday, September 21, 2025
Friday, August 8, 2025
Wednesday, August 6, 2025
Friday, August 1, 2025
Democratizing Surgery: A New Era #surgicalpioneering #genesisjournal #sh...
Democratizing Surgery: A New Era
So our mission today is to unpack how this journal aims to, well, revolutionize the sharing of critical medical insights, making it more accessible and truly global. And what's fascinating right from that editorial note is how it lays out this vision. It's not just about publishing papers. No, it's about genuinely democratizing knowledge in such a crucial field, especially now, you know, with information overload being such a real thing. Right. And open access in science is just, it's more vital than ever for actual global health progress. It feels like they're trying to break down some old barrier. Okay, let's unpack that vision then. Dr. Lankarani, as you mentioned, a surgeon himself and now on the CJSM editorial board, talks about a new era. So what is the core philosophy driving this journal? What makes it a new era? Well, I think the Genesis Journal of Surgery and Medicine, GJSM, it's fundamentally committed to advancing global medical knowledge, yes, but it's how that's different. The editorial really emphasizes things like interdisciplinary collaboration, radical accessibility. We'll probably get into that more rigorous peer review, of course, but also genuine inclusivity and a real drive for innovation. So not just the usual academic checkboxes. Exactly. It feels like a strategic response to, you know, the traditional gatekeepers and the silos you often see in medical publishing. And Dr. Linkarani's background, I mean, as a surgeon, plus founding the Surgical Pioneering newsletter and podcast series, he's clearly dedicated to pushing surgical innovation through research and education. Right. Connecting the two. Precisely. He seems to see the journal as a key channel for that, recognizing that progress doesn't just happen in a few elite places. It thrives when knowledge flows freely, ethically and globally.
Friday, July 25, 2025
Surgical Pioneering and Surgical Innovation Podcast Intro by Dr Reza Lankarani, General Surgeon and Founder of Surgical Pioneering Newsletter and Podcast Series
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