Do Surgeons Safely Use Surgical Energy? Testing at a Military Medical Center
Ally Ha, MD, Erik Criman, MD, Carly Richards, MD, Robert B Lim, MD. Tripler Army Medical CenterOBJECTIVE: While the use of surgical energy is ubiquitous in modern operating rooms, its safe use is not part of routine surgical training. Injuries and complications from electrical devices can be devastatingly severe, yet there is no current established… Continue Reading
- Topic:
- General Surgery
Factors Influencing the Accuracy of Right Upper Quadrant Ultrasound in Estimating Gallbladder Wall Thickness
Lindsay Cefalu, MD, CPT, Robert McMurray, MD, CPT, Gerald Bieniek, MD, CPT, Christopher Yheulon, MD, MAJ. Tripler Army Medical CenterBackground: Right upper quadrant ultrasound is the standard initial diagnostic imaging modality for evaluating gallbladder pathology, although it has great variability in both sensitivity and specificity. The quality of ultrasound can be influenced by a variety… Continue Reading
- Topic:
- General Surgery
Hypertension Resolution after Bariatric Surgery
Devon Hawkins, MD, Balakrishna Prasad, PhD, Byron Faler, MD, Yong Choi, MD. Eisenhower Army Medical CenterBackground: Bariatric surgery has become the most effective means for long term weight loss and resolution of comorbid conditions such as hypertension and diabetes. While the majority of the literature focuses on diabetes remission following bariatric surgery little has been… Continue Reading
- Topic:
- General Surgery
Improved disease-free survival in endometrial and ovarian cancer patients with low folate binding protein expression after treatment with the E39 peptide vaccine in a phase I/IIa trial
Kaitlin M Peace, MD1, Diane F Hale, MD1, Timothy J Vreeland, MD2, Doreen O Jackson, MD1, Julia M Greene, MD1, John S Berry, MD3, Alfred F Trappey, MD4, Garth S Herbert, MD1, Guy T Clifton, MD1, Mark O Hardin, MD5, Kathleen M Darcy, PhD6, Chad A Hamilton, MD6, G. Larry Maxwell, MD6, George E Peoples,… Continue Reading
- Topic:
- General Surgery
Incidence of Surgical Cancers during Humanitarian Relief Missions: An Ethical Dilemma
Ryan J Schutt, LT, MC, USN, John Walsh, LT, MC, USN, Frank Zuehl, MD, Jason Brill, LCDR, MC, USN, Louis Rivera, CDR, MC, USN, Romeo Ignacio, CAPT, MC, USN. Naval Medical Center San DiegoBackground: The USNS Mercy is the largest floating hospital ship in the world that participates in humanitarian and disaster relief training (HA/DR)… Continue Reading
- Topic:
- General Surgery
Laparoscopic Roux-en-Y Gastric Bypass versus Laparoscopic Sleeve Gastrectomy as a Revision Procedure for Failed Laparoscopic Adjustable Gastric Banding – A Retrospective Review of Outcomes in a Military Treatment Center
Seth R Holland, DSc, PAC, Michael Smith, DSc, PAC, Jason Pfluke, MD. San Antonio Military Medical CenterIntroduction: The high failure rate of Laparoscopic Adjustable Gastric Banding (LAGB) due to mechanical failure, gastroesophageal reflux disorder (GERD), dysphagia, or failure of satisfactory weight loss is well established. Controversy exists regarding the best procedure for revising the failed… Continue Reading
- Topic:
- General Surgery
Litigation Patterns in Inguinal Hernia Surgery: A 25 Year Review
C.t. Grayson, MD, MPH, Erik Criman, MD, Lindsay Cefalu, MD, Erik Roedel, MD, Christopher Yheulon, MD. Tripler Army Medical CenterObjectives: Practitioners in high-risk specialties, such as general surgery, are estimated to have a 99% likelihood of facing litigation over the course of their career. Our group sought to quantify the litigation patterns in inguinal hernia… Continue Reading
- Topic:
- General Surgery
Military vs Civilian Centers for Index Cancer Operations: Are 30 day outcomes really that different?
John P Kuckelman, DO, John M McClellan, MD, Jason Bingham, MD, Douglas Stoddard, MD, MBA, Vance Sohn, MD. Madigan Army Medical CenterIntroduction: A growing body of literature suggests that high-volume centers have better outcomes and lower complication rates in major oncological procedures. However, no Department of Defense (DoD) facility meets the high-volume threshold and yet… Continue Reading
- Topic:
- General Surgery
New Prey for the Linx®: Standard Versus Expanded Indications for Esophageal Magnetic Sphincter Augmentation for Reflux Disease
John P Kuckelman, DO, Cody J Phillips, Mark O Hardin, Matthew J Martin, MD. Madigan Army Medical CenterOBEJCTIVE: To describe outcomes with Linx magnetic sphincter augmentation (MSA), and compare outcomes based on standard versus expanded criteria. BACKGROUND: The Linx device has proven safe and effective for appropriate candidates with GERD. Standard indications include GERD with… Continue Reading
- Topic:
- General Surgery
Panniculectomy after Bariatric Surgery: A Morbid Procedure after Morbid Obesity
Michael J Derickson, MD, Cody J Phillips, DO, Morgan R Barron, MD, John P Kuckelman, DO, Mia D DeBarros, MD, Matthew J Martin, MD. Madigan Army Medical CenterINTRODUCTION: Bariatric surgery often results in rapid massive weight loss, leaving many with redundant skin that can cause significant physical and psychosocial limitations. Body contouring procedures in this… Continue Reading
- Topic:
- General Surgery
Performance Outcomes at a Military Treatment Facility after Implementation of Enhanced Recovery Pathway for Elective Colonic Surgery
Ally Ha, MD, Carly R Richards, MD, Robert B Lim, MD, Suzanne M Gillern, MD. Tripler Army Medical CenterOBJECTIVE: Multimodal care, including Enhanced Recovery After Surgery (ERAS) pathway, is designed to achieve early recovery for patients undergoing major surgery and is the current standard of care in colorectal surgery. The individual elements that have been… Continue Reading
- Topic:
- General Surgery
Serum Lactate Predicts Resource Utilization, But Not Surgical Need, in the Emergency Department Setting
Kelli Ishihara, MD, C.t. Grayson, MD, MPH, Carly Richards, MD, MPH, Michael Lustik, MS, Christopher Yheulon, MD. Tripler Army Medical CenterObjectives: Serum lactate is frequently tested in the Emergency Department (ED) setting to diagnose visceral ischemia and as a marker of end-organ perfusion. In the setting of abdominal pain, it is useful in the diagnosis… Continue Reading
- Topic:
- General Surgery
The Cost of Large Scale Humanitarian Missions On Surgical Services at Military Treatment Facilities
James D Wallace, MD, Jason B Brill, MD, Paul R Lewis, DO, Matthew S Christman, MD, Eamon B O'Reilly, MD, Marion C Henry, MD, Romeo C Ignacio, MD. Naval Medical Center San Diego (NMCSD)Objective: Surgical humanitarian aid (HA) has recently received greater attention as research has demonstrated the value of global surgery in low middle… Continue Reading
- Topic:
- General Surgery