Scholars@Duke
Ozanan Meireles

Ozanan Meireles

Associate Professor of Surgery
Surgery, Minimally Invasive Surgery
ozanan.meireles@duke.edu
DUMC 3704, Durham, NC 27710
2301 Erwin Road, Hafs 7th Floor, Room 7688B, Durham, NC 27710

Selected Publications

Safety and cost of performing laparoscopic sleeve gastrectomy with same day discharge at a large academic hospital.

Journal Article Surg Endosc · April 2024 BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most common surgical treatment for morbid obesity. While certain specialized ambulatory surgery centers offer LSG on an outpatient basis, patients undergoing LSG at most academic centers are admitted ... Full text Link to item Cite

Concept Graph Neural Networks for Surgical Video Understanding.

Journal Article IEEE Trans Med Imaging · January 2024 Analysis of relations between objects and comprehension of abstract concepts in the surgical video is important in AI-augmented surgery. However, building models that integrate our knowledge and understanding of surgery remains a challenging endeavor. In t ... Full text Link to item Cite

SAGES consensus recommendations on surgical video data use, structure, and exploration (for research in artificial intelligence, clinical quality improvement, and surgical education).

Journal Article Surg Endosc · November 2023 BACKGROUND: Surgery generates a vast amount of data from each procedure. Particularly video data provides significant value for surgical research, clinical outcome assessment, quality control, and education. The data lifecycle is influenced by various fact ... Full text Link to item Cite

Application of artificial intelligence in oncologic surgery of the upper gastrointestinal tract

Journal Article Onkologie · June 1, 2023 Background: The application of artificial intelligence (AI) to minimally invasive surgery has the potential to improve surgical safety, support intraoperative decision making, and reduce operative complications. Computer vision and machine learning are sub ... Full text Cite

SAGES video acquisition framework-analysis of available OR recording technologies by the SAGES AI task force.

Journal Article Surg Endosc · June 2023 BACKGROUND: Surgical video recording provides the opportunity to acquire intraoperative data that can subsequently be used for a variety of quality improvement, research, and educational applications. Various recording devices are available for standard op ... Full text Link to item Cite

TEsoNet: knowledge transfer in surgical phase recognition from laparoscopic sleeve gastrectomy to the laparoscopic part of Ivor-Lewis esophagectomy.

Journal Article Surg Endosc · May 2023 BACKGROUND: Surgical phase recognition using computer vision presents an essential requirement for artificial intelligence-assisted analysis of surgical workflow. Its performance is heavily dependent on large amounts of annotated video data, which remain a ... Full text Link to item Cite

Do the costs of robotic surgery present an insurmountable obstacle? A narrative review

Journal Article International Journal of Abdominal Wall and Hernia Surgery · April 1, 2023 With increasing market size and rising demand, the question arises whether the high cost impedes accessibility to robotic surgery. Despite all the apparent advantages robotic surgery offers to surgeons and patients, it is imperative for healthcare provider ... Full text Cite

Multicentric exploration of tool annotation in robotic surgery: lessons learned when starting a surgical artificial intelligence project.

Journal Article Surg Endosc · November 2022 BACKGROUND: Artificial intelligence (AI) holds tremendous potential to reduce surgical risks and improve surgical assessment. Machine learning, a subfield of AI, can be used to analyze surgical video and imaging data. Manual annotations provide veracity ab ... Full text Link to item Cite

Artificial intelligence prediction of cholecystectomy operative course from automated identification of gallbladder inflammation.

Journal Article Surg Endosc · September 2022 BACKGROUND: Operative courses of laparoscopic cholecystectomies vary widely due to differing pathologies. Efforts to assess intra-operative difficulty include the Parkland grading scale (PGS), which scores inflammation from the initial view of the gallblad ... Full text Link to item Cite

Robotic-assisted minimally invasive esophagectomy (RAMIE) for esophageal cancer training curriculum-a worldwide Delphi consensus study.

Journal Article Dis Esophagus · June 15, 2022 BACKGROUND: Structured training protocols can safely improve skills prior initiating complex surgical procedures such as robotic-assisted minimally invasive esophagectomy (RAMIE). As no consensus on a training curriculum for RAMIE has been established so f ... Full text Link to item Cite

Artificial Intelligence Methods and Artificial Intelligence-Enabled Metrics for Surgical Education: A Multidisciplinary Consensus.

Journal Article J Am Coll Surg · June 1, 2022 BACKGROUND: Artificial intelligence (AI) methods and AI-enabled metrics hold tremendous potential to advance surgical education. Our objective was to generate consensus guidance on specific needs for AI methods and AI-enabled metrics for surgical education ... Full text Link to item Cite

SUPR-GAN: SUrgical PRediction GAN for Event Anticipation in Laparoscopic and Robotic Surgery

Journal Article IEEE Robotics and Automation Letters · April 1, 2022 Comprehension of surgical workflow is the foundation upon which artificial intelligence (AI) and machine learning (ML) holds the potential to assist intraoperative decision making and risk mitigation. In this work, we move beyond mere identification of pas ... Full text Cite

Surgical data science - from concepts toward clinical translation.

Journal Article Med Image Anal · February 2022 Recent developments in data science in general and machine learning in particular have transformed the way experts envision the future of surgery. Surgical Data Science (SDS) is a new research field that aims to improve the quality of interventional health ... Full text Link to item Cite

Artificial Intelligence in Surgery

Chapter · January 1, 2022 Artificial intelligence (AI) is the study of algorithms that give machines the ability to reason and perform cognitive functions. Applications of AI in medicine broadly and surgery, more specifically, have grown over the last few years as technology has ad ... Full text Cite

A Deep Concept Graph Network for Interaction-Aware Trajectory Prediction

Conference Proceedings - IEEE International Conference on Robotics and Automation · January 1, 2022 Temporal patterns (how vehicles behave in our observed past) underline our reasoning of how people drive on the road, and can explain why we make certain predictions about interactions among road agents. In this paper we propose the ConceptNet trajectory p ... Full text Cite

ADAMTSL2 protein and a soluble biomarker signature identify at-risk non-alcoholic steatohepatitis and fibrosis in adults with NAFLD.

Journal Article J Hepatol · January 2022 BACKGROUND & AIMS: Identifying fibrosis in non-alcoholic fatty liver disease (NAFLD) is essential to predict liver-related outcomes and guide treatment decisions. A protein-based signature of fibrosis could serve as a valuable, non-invasive diagnostic tool ... Full text Link to item Cite

Distinct Hepatic Gene-Expression Patterns of NAFLD in Patients With Obesity

Journal Article Hepatology Communications · January 1, 2022 Approaches to manage nonalcoholic fatty liver disease (NAFLD) are limited by an incomplete understanding of disease pathogenesis. The aim of this study was to identify hepatic gene-expression patterns associated with different patterns of liver injury in a ... Full text Cite

Challenges in surgical video annotation.

Journal Article Comput Assist Surg (Abingdon) · December 2021 Annotation of surgical video is important for establishing ground truth in surgical data science endeavors that involve computer vision. With the growth of the field over the last decade, several challenges have been identified in annotating spatial, tempo ... Full text Link to item Cite

SAGES consensus recommendations on an annotation framework for surgical video.

Journal Article Surg Endosc · September 2021 BACKGROUND: The growing interest in analysis of surgical video through machine learning has led to increased research efforts; however, common methods of annotating video data are lacking. There is a need to establish recommendations on the annotation of s ... Full text Link to item Cite

Automated operative phase identification in peroral endoscopic myotomy.

Journal Article Surg Endosc · July 2021 BACKGROUND: Artificial intelligence (AI) and computer vision (CV) have revolutionized image analysis. In surgery, CV applications have focused on surgical phase identification in laparoscopic videos. We proposed to apply CV techniques to identify phases in ... Full text Link to item Cite

Computer vision in surgery.

Journal Article Surgery · May 2021 The fields of computer vision (CV) and artificial intelligence (AI) have undergone rapid advancements in the past decade, many of which have been applied to the analysis of intraoperative video. These advances are driven by wide-spread application of deep ... Full text Link to item Cite

Artificial Intelligence

Chapter · January 1, 2021 Artificial intelligence (AI) is a new method of computer science and associated fields to create the ability for machines to establish reasoning and perform cognitive functions. One can differentiate in “strong AI” and “weak AI.” The aim of these applicati ... Full text Cite

Aggregating Long-Term Context for Learning Laparoscopic and Robot-Assisted Surgical Workflows

Conference Proceedings - IEEE International Conference on Robotics and Automation · January 1, 2021 Analyzing surgical workflow is crucial for surgical assistance robots to understand surgeries. With the understanding of the complete surgical workflow, the robots are able to assist the surgeons in intra-operative events, such as by giving a warning when ... Full text Cite

The AI Guardian for surgery

Chapter · March 17, 2020 Full text Cite

Artificial Intelligence in Anesthesiology: Current Techniques, Clinical Applications, and Limitations.

Journal Article Anesthesiology · February 2020 Artificial intelligence has been advancing in fields including anesthesiology. This scoping review of the intersection of artificial intelligence and anesthesia research identified and summarized six themes of applications of artificial intelligence in ane ... Full text Link to item Cite

Computer Vision Analysis of Intraoperative Video: Automated Recognition of Operative Steps in Laparoscopic Sleeve Gastrectomy.

Journal Article Ann Surg · September 2019 OBJECTIVE(S): To develop and assess AI algorithms to identify operative steps in laparoscopic sleeve gastrectomy (LSG). BACKGROUND: Computer vision, a form of artificial intelligence (AI), allows for quantitative analysis of video by computers for identifi ... Full text Link to item Cite

Fundamental use of surgical energy during endoscopic therapies

Journal Article Annals of Laparoscopic and Endoscopic Surgery · August 1, 2019 Knowledge of the principles of safe use of surgical energy is a critical element in the practice of any endoscopist. We review the basic principles of electrosurgical energy as taught by the Fundamental Use of Surgical Energy curriculum and then provide en ... Full text Cite

Risk factors and prevalence of liver disease in review of 2557 routine liver biopsies performed during bariatric surgery.

Journal Article Surg Obes Relat Dis · June 2019 BACKGROUND: Obesity is a known risk factor for nonalcoholic fatty liver disease (NAFLD). However, among individuals undergoing bariatric surgery, the prevalence and risk factors for NAFLD, as well as distinct phenotypes of steatosis, nonalcoholic steatohep ... Full text Link to item Cite

Combined surgical and endoscopic approaches to full-thickness resection

Journal Article Techniques in Gastrointestinal Endoscopy · January 1, 2019 With the emergence of advanced endoscopic technologies and techniques, endoscopic resection has emerged as an important therapeutic modality. However, endoscopic full-thickness resection can be limited by concerns for R0 resection, margins, potential for s ... Full text Cite

Robotic transhiatal esophagectomy

Chapter · December 17, 2018 The first published report of robotic esophagectomy was in 2002, the transhiatal approach. Patients with severe dysplasia and early stage esophageal cancer, end-stage achalasia, severe refractory reflux disease, and other end-stage esophageal diseases that ... Full text Cite

Surgical Video in the Age of Big Data.

Journal Article Ann Surg · December 2018 Full text Link to item Cite

Artificial Intelligence in Surgery: Promises and Perils.

Journal Article Ann Surg · July 2018 OBJECTIVE: The aim of this review was to summarize major topics in artificial intelligence (AI), including their applications and limitations in surgery. This paper reviews the key capabilities of AI to help surgeons understand and critically evaluate new ... Full text Link to item Cite

Sleeve gastrectomy telementoring: a SAGES multi-institutional quality improvement initiative.

Journal Article Surg Endosc · February 2018 BACKGROUND: Sleeve gastrectomy is a relatively new procedure that developed as a result of rapid innovation in the field of bariatric surgery. As with any newly developed operation, there is a learning curve that potentially can be associated with higher m ... Full text Link to item Cite

Machine learning and coresets for automated real-time video segmentation of laparoscopic and robot-assisted surgery

Conference Proceedings - IEEE International Conference on Robotics and Automation · July 21, 2017 Context-aware segmentation of laparoscopic and robot assisted surgical video has been shown to improve performance and perioperative workflow efficiency, and can be used for education and time-critical consultation. Modern pressures on productivity preclud ... Full text Cite

A blinded assessment of video quality in wearable technology for telementoring in open surgery: the Google Glass experience.

Journal Article Surg Endosc · January 2016 BACKGROUND: The goal of telementoring is to recreate face-to-face encounters with a digital presence. Open-surgery telementoring is limited by lack of surgeon's point-of-view cameras. Google Glass is a wearable computer that looks like a pair of glasses bu ... Full text Link to item Cite

Posterior reversible encephalopathy syndrome (PRES) after bariatric surgery--a potential consequence associated with rapid withdrawal of antihypertensive medications.

Journal Article BMJ Case Rep · December 23, 2015 A 61-year-old woman with a medical history of intracerebral haemorrhage, hypertension, hyperlipidaemia and carotid stenosis presented to the emergency department with altered mental status 3 weeks after undergoing a vertical sleeve gastrectomy for severe o ... Full text Link to item Cite

Roux-en-Y gastric bypass is associated with an increased exposure to ionizing radiation.

Journal Article Surg Obes Relat Dis · 2015 BACKGROUND: Bariatric surgery provides for a reliable and sustainable solution to the obesity epidemic. The gold standard bariatric surgical procedure is the Roux-en-Y gastric bypass (RYGB). Assessment of this population preoperatively and work-up of posto ... Full text Link to item Cite

Broad clinical utilization of NOTES: is it safe?

Journal Article Surg Endosc · June 2013 BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) has been the focus of several studies as a less invasive alternative to conventional laparoscopy to access and treat intracavitary organs. For the last 5 years, much has been accomplished ... Full text Link to item Cite

Transesophageal endoscopic myotomy (TEEM) for the treatment of achalasia: The United States human experience

Journal Article Surgical Endoscopy · January 1, 2013 Background: From our early experience with NOTES, our group has acquired familiarity with transesophageal submucosal dissection and myotomy in swine model, which allowed us to perfect a model to perform purely endoscopic transesophageal myotomy (TEEM) for ... Full text Cite

Applications of surgical robotics in general surgery

Chapter · December 1, 2011 From the first laparoscopic cholecystectomy performed in 1985 to the introduction of robotic surgical telemanipulators in general surgery in the early 2000s, the field of general surgery has changed tremendously, to the point that isn't general anymore; in ... Full text Cite

Reliable gastric closure after natural orifice translumenal endoscopic surgery (NOTES) using a novel automated flexible stapling device.

Journal Article Surg Endosc · July 2008 BACKGROUND: Reliable closure of the translumenal incision is one of the main challenges facing natural orifice translumenal endoscopic surgery (NOTES). This study aimed to evaluate the use of an automated flexible stapling device (SurgASSIST) for closure o ... Full text Link to item Cite

Hybrid minimally invasive surgery--a bridge between laparoscopic and translumenal surgery.

Journal Article Surg Endosc · August 2007 BACKGROUND: The peroral transluminal approach to the peritoneal cavity appears safe, feasible, and may further reduce the invasiveness of surgery. However, flexible endoscopes have multiple limitations inside the peritoneal cavity, which can potentially be ... Full text Link to item Cite

Comparison of intraabdominal pressures using the gastroscope and laparoscope for transgastric surgery.

Journal Article Surg Endosc · June 2007 BACKGROUND: The peroral transgastric endoscopic approach for intraabdominal procedures appears to be feasible, although multiple aspects of this approach remain unclear. This study aimed to measure intraperitoneal pressure in a porcine model during the per ... Full text Link to item Cite