You Are What You Measure: Take Charge of Your Individual Surgeon Metric Data or Someone Else Will
Kevin R Kasten, MD1, Konstantinos Spaniolas, MD2. 1Carolinas HealthCare System, 2Stony Brook Medical CenterIntroduction: The last decade yielded myriad studies of surgical outcomes using large datasets. Unfortunately, the National Surgical Quality Improvement Program (NSQIP) and Thoracic Morbidity and Mortality System (TMMS) datasets were developed with institutional outcomes in mind. In an attempt to quantify individual… Continue Reading
- Topic:
- Outcomes and Quality
Xanthogranulomatous cholecystitis: a challenging laparoscopic cholecystectomy 3 case report
Floryn Cherbanyk1, Maria Dimitrief1, Hon Lai Chan1, A. Stanescu2, Petra Rosskopfova1, Alexis Litchinko1, Olivier Martinet1, Daniel Roulet1, Edgardo Pezzetta1. 1Department of General Surgery, Riviera-Chablais Hospital, 1820 Montreux-Switzerland, 2Department of General Surgery, HFR Fribourg, 1700 SwitzerlandIntroduction: Even if nowadays is considered a routine, standardized and well mastered procedure, laparoscopic cholecystectomy may become a difficult challenge in… Continue Reading
- Topic:
- Case Presentations
Wound Infection and Surgical Site Infection in Laparoscopic Colorectal Surgery Can Be Minimized
Henry P Schoonyoung, MD1, Andrew R Helber, AB1, Barath Krishnan, MD2, Gerald J Marks, MD1, John H Marks, MD1. 1Lankenau Medical Center, Marks Colorectal Surgical Associates, 2Lankenau Medical CenterSurgical site infection (SSI) is common after colorectal surgery. With superficial SSI rates ranging from 5–30%, we hypothesize that performing laparoscopic procedures using a strict clean and… Continue Reading
- Topic:
- Colorectal
Wondering Spleen; a Report of Two Cases, One Complicated by Acute Torsion
Hamdy S Abd Alla, Mohamad H Abo-Raya, PhD, Sherief A Saber, MD, Ahmad A Alshoora, MD, Sherief M Algarf, MSc, Ossama H Elkhadrawy, PhD, Gamal I Moussa, PhD. Faculty of medicine, Tanta university HospitalIntroduction: Wandering spleen is a very rare condition. Patients may be asymptomatic or present with an abdominal mass. Occasionally, patients present with… Continue Reading
- Topic:
- Case Presentations
Why Is My Gastric Band Patient Still Gaining Weight?
Esther H Cha, MD1, Shadi Al-Bahri, MD2, Michel M Murr, MD2. 1Medstar Union Memorial Hospital, 2University of South Florida – Tampa General HospitalIntroduction: Lipomas are well-defined, encapsulated benign tumor of mature adipose tissue commonly located in the subdermal tissues of the trunk and extremities. However, primary intestinal mesenteric lipomas are rare. They are usually asymptomatic… Continue Reading
- Topic:
- Case Presentations
When to Operate on Gallbladder Polyps in Chinese-Americans
Carmen F Fong1, Joanne Ling2, David Pechman1, Steven Cai, MD1. 1Mount Sinai Beth Israel, 2CUNY Medical SchoolBackground: The current teaching is that gallbladder polyps greater than 1cm need to be resected via cholecystectomy. Many of these polypoid lesions are benign on final pathology and the benefit of the patient undergoing surgery is unclear. The literature… Continue Reading
- Topic:
- Biliary
Watchful Waiting versus Elective Laparoscopic Repair for Minimally Symptomatic Paraesophageal Hernias: A Cost-Effectiveness Analysis
Ellen H Morrow, MD, Jennwood Chen, MD, Richard Nelson, PhD, Raminder Nirula, MD, MPH, Robert Glasgow, MD. University of UtahIntroduction: In this study, we aimed to evaluate the management strategies of watchful waiting versus elective laparoscopic hernia repair for minimally symptomatic paraesophageal hernias (PEH). The current recommendation for minimally symptomatic PEHs is watchful waiting. This… Continue Reading
- Topic:
- Foregut
Visceral Pseudoaneurysm after Revisional Bariatric Surgery: Report of two cases
Charlotte Horne, MD, Antonis Sideris, MD, Ali Aminian, MD, Stacy Brethauer, MD, Phillip Schauer, MD. Cleveland ClinicIntroduction: As obesity is a chronic disease, subsequent surgical procedures may be required either due to poor response to, or complications of the initial procedure. Revisional surgery is associated with increased risk of post-operative hemorrhage with reported rates of… Continue Reading
- Topic:
- Metabolic / Obesity
Virtual Reality Simulation in Flexible Endoscopy: Implications for Resident Training
David S Strosberg1, Sylvester N Osayi1, Joseph Drosdeck2, Rebecca Dettorre1, Andrew Suzo1, Jeffrey Hazey1. 1The Ohio State University Wexner Medical Center, 2Oregon Health and Science UniversityBackground: Endoscopic training for general surgical residents has been traditionally accomplished using the apprenticeship model. Given the limitations and controversies of current endoscopy training, Flexible Endoscopic Curriculum (FEC) was adopted… Continue Reading
- Topic:
- Education / Simulation
Viewer Discretion Advised – Is YouTube a Friend or Foe in Surgical Education?
Alejandro Rodriguez-Garcia, MD, Monica T Young, MD, Hope T Jackson, MD, Brant K Oelschlager, MD, Andrew S Wright, MD. University of WashingtonIntroduction: Online operative videos represent an important resource in surgical education and are used by 95% of residents, with YouTube being the most commonly accessed source. The user-generated nature of videos hosted on YouTube… Continue Reading
- Topic:
- Education / Simulation
Video presentation: Rectal heterotrophic gastric mucosa
Chaya Shwaartz, MD, Alexandra Argiroff, MD, Sanghyun A Kim, MD, FACS. Icahn School of Medicine at Mount SinaiWe present the case of rectal heterotopic gastric mucosa excised using transanal endoscopic microsurgery. The patient is a 36-year-old male who presented with intermittent rectal bleeding. He denied any weight loss. His labs were within normal limits. On… Continue Reading
- Topic:
- Colorectal
Video presentation: Laparoscopic Splenic Cystectomy
Chaya Shwaartz, MD, David J Berler, MD, Celia M Divino, MD, FACS, Scott Q Nguyen, MD, FACS, Linda P Zhang, MD, FACS, Edward H Chin. Icahn School of Medicine at Mount SinaiThis is the case of a 14-year-old female with no past medical or surgical history who presented in the ambulatory setting with a complaint… Continue Reading
- Topic:
- Solid Organ and Endocrine
Video Presentation: Laparoscopic Resection of a Large Retroperitoneal Teratoma
Joseph Kim, MD, Spiros Hiotis, MD, PhD, Scott Q Nguyen, MD. Mount SinaiRetroperitoneal teratomas are very rare, consisting of 1-11% of all primary retroperitoneal masses. They are usually asymptomatic and found incidentally on imaging. However, when they grow large enough, they can cause a mass effect on surrounding organs and cause abdominal symptoms. The treatment… Continue Reading
- Topic:
- Minimally Invasive Other
Video Presentation: Laparoscopic Conversion of Roux-en-Y Gastric Bypass to Biliopancreatic Diversion with Duodenal Switch
Jingjing L Sherman, MD, David M Brams, MD, FACS, Dmitry Nepomnayshy, MD, FACS. Lahey Medical CenterGastric bypass is the gold standard for obesity and its related comorbid conditions. However, 20% of patients fail gastric bypass. Failure is defined as excess weight loss less than 50% or BMI greater than 35. For patients who fail gastric… Continue Reading
- Topic:
- Metabolic / Obesity
Video: Laparoscopic J-tube Placement
Maija Cheung, MD, Salim Munoz, MD, Matthew Hubbard. Yale New Haven HospitalA 60 year-old male with a history of erosive esophagitis s/p a distal esophagectomy and gastrectomy with colonic interposition graft was admitted to the Neurology service with progressive weakness of his upper extremities and was diagnosed with a variant of Guillan Barre Syndrome. He… Continue Reading
- Topic:
- Minimally Invasive Other