Use of in silico research in the development of abdominal and thoracic surgical devices : a systematic review
Pattani, Nikhil Sanghera, Jaspinder Mills, Emily Khan, Adam Jauniaux, Benoit William Bolton, William Harji, Deena Burke, Joshua Richard
Pattani, Nikhil
Sanghera, Jaspinder
Mills, Emily
Khan, Adam
Jauniaux, Benoit
William Bolton, William
Harji, Deena
Burke, Joshua Richard
Affiliation
St George’s University Hospitals NHS Foundation Trust; Walsall Healthcare NHS Trust; Mid Essex Hospital Services NHS Trust; University of Leeds; Manchester University NHS Foundation Trust
Other Contributors
Publication date
2025-06-26
Subject
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
Objective Surgical innovation has exponentially improved over the past three decades. However, efficacy assessment of surgical devices through randomised controlled trials requires significant resources. In silico modelling may provide a solution, utilising computational simulations to develop and improve devices. This study aims to evaluate the current use of in silico modelling for devices used in abdominal and thoracic surgery.
Design A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
Data Resources PubMed, MEDLINE and Embase databases from January 2019 to August 2024 were searched.
Eligibility criteria for selecting studies Inclusion criteria were defined as studies using mathematical/computational models to investigate invasive devices implanted or incorporated in abdominal and thoracic surgery.
Results The search strategy yielded 2968 studies, with 42 included in the final analysis. Core themes identified included proof of concept (n=19), device improvement (n=22) and in silico clinical trials with simulated human patients (n=1). Specialities included: general surgery (n=4); hepato-pancreato-biliary (n=2); vascular (n=5); paediatric (n=9) and cardiothoracic (n=22). Most studies were at IDEAL stage 0 (preclinical) and 19 studies validated in silico results with in vitro/in vivo data.
Conclusion In silico modelling can complement preclinical in vitro and in vivo testing for surgical devices. Its applications include simulating rare diseases, modelling diverse patient demographics, and generating early efficacy data for novel or repurposed devices. Standardising methodologies through a core outcome set and credibility framework is essential to reduce inter-study heterogeneity. Global collaboration and clear regulatory guidance are key for its integration into mainstream surgical device research.
Citation
Pattani N, Sanghera J, Mills E, Khan A, Jauniaux B, Bolton W, Harji D, Burke JR. Use of in silico research in the development of abdominal and thoracic surgical devices: a systematic review. BMJ Innov. 2025 Jun 26;11(3):e001348. doi: 10.1136/bmjinnov-2024-001348. PMID: 41293220; PMCID: PMC12642822.
Type
Article