CT Scans and Acute Appendicitis; A Five Year Analysis From a Rural, Teaching Hospital
INTRODUCTION: Studies conducted in urban centers examining the relationship between CT scans, negative appendectomies and appendiceal perforation are not applicable to rural centers due to higher proportion of older adults, difficult access and absence of management algorithms at most centers.METHODS AND PROCEDURES: Retrospective analysis of all patients who underwent appendectomies from January 2000 to June… Continue Reading
- Type:
- Posters
- Topic:
- Colorectal
Current Status of Laparoscopy-Assisted Surgery for Colorectal Cancer in Cancer Institute Hospital in Japan
Introduction: Laparoscopic surgery was introduced for the treatment of colorectal cancer about 15 years ago in Japan and now has been rapidly widespread. The objective of this study was to demonstrate the safety and feasibility of laparoscopy-assisted surgery for colorectal cancer in aspects of treatment results and expenses as compared to open surgery.Patients and Methods:… Continue Reading
- Type:
- Posters
- Topic:
- Colorectal
Current Status of Laparospic Education and Training in United States Surgical Residency Programs. Are We Doing Enough?
Background: The amount of laparoscopic training provided to surgical residents varies widely from institution to institution. Consequently, the ability to safely perform complex laparoscopic procedures also likely varies. Nonetheless, graduating residents are expected to perform laparoscopic procedures independently without additional training. The extent to which residents are adequately trained for such procedures is unclear. Methods:… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation
CyberDome, novel 3-dimension hemispherical display system, improves procedures of laparoscopic surgery
(Background) Despite of current advances with technology associated with laparoscopic surgery, laparoscopic surgeons still need a long experience to overcome the lack of depth perception on a 2-dimensional (2D) display. Although it was reported over two decades that 3-dimensional (3D) imaging provided depth perception and might improve laparoscopic procedures, 3D systems have not been widely… Continue Reading
Day case laparoscopic cholecystectomy in the elderly
INTRODUCTION: Laparoscopic cholecystectomy (LC) is the gold standard treatment for cholelithiasis, and surgeons are increasingly looking towards day case procedures. However, only 6% of UK LCs are performed as day case (DC) (i.e. same day discharge without overnight stay) or extended day case ( 80 years old. 46% of patients stayed longer than 23 hours.… Continue Reading
Deconstructing Operative Flow – a Focus on Anticipatory Movements
Introduction: Efficient instrument movement is a vital part of a well-coordinated operating environment, and is a reflection of optimized ergonomic and human factor issues. In order to make assessments of these movements, objective, reproducible metrics are needed. In this study, instrument flow analysis is utilized to characterize anticipatory movements of the operative team.Methods: Five laparoscopic… Continue Reading
Decreased expression of hepatic signaling phosphoproteins after laparoscopic and hand-Assisted surgery
Background: Minimally-invasive surgery is associated with a decreased activation of both systemic and peritoneal immunity as compared to the open (O) technique. However, the hepatic response to laparoscopic (L) and hand-assisted (HA) surgery has not been defined well. We postulated that both laparoscopic and hand-assisted approaches are associated with a diminished expression of hepatic pro-inflammatory… Continue Reading
- Type:
- Posters
- Topic:
- Basic Science
Defining Differences among those who Succeed in Compared to those who Fail to Lose Significant Excessive Weight after Bariatric Surgery
Background: Gastric bypass and adjustable gastric banding are currently the most commonly performed weight loss surgeries. The results are encouraging for most patients; however, even among surgeons that perform hundreds of these procedures, some of their patients do better than others. This article has set out to define differences among those that succeed compared to… Continue Reading
- Type:
- Posters
- Topic:
- Metabolic / Obesity
Demonstration of increasing laparoscopic clinical skill over time: Use of a new network-based resident assessment tool.
Background: The assessment of resident skill in laparoscopic surgery under actual clinical conditions is a difficult, but increasingly mandated process. We sought to demonstrate the utility of a new computer-based assessment tool to capture predictable incremental increases in resident skill over time. Methods: Using a network-based database instrument, performance of a group of 6 residents… Continue Reading
- Type:
- Posters
- Topic:
- Education / Simulation
Development of minimally invasive surgery in infants less than 5kg: The first decade’s experience
Introduction: Pediatric minimally invasive surgery (MIS) has undergone significant development over the last 10 years but the role in complex neonatal and infant surgery is still being evaluated.. Technical advances and new procedures have allowed the evolution of MIS in even the smallest neonates. This report documents our experience in MIS in infants under 5kg.Methods:… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Minimally Invasive Other
Diagnosis of Malignant vs. Benign Disease as an Accurate Predictor of Outcome After Laparoscopic Splenectomy
Introduction: The aim of this study is to determine if a diagnosis of malignant vs. benign disease is an accurate predictor of patient outcome after laparoscopic splenectomy (LS). Methods: A comprehensive retrospective chart review of all patients undergoing LS from April 1994 through August 2007 was conducted. Statistical methods used included Fisher’s Exact Test, Student’s… Continue Reading
- Type:
- Posters of Distinction
- Topic:
- Solid Organ and Endocrine
Different Outcome of GERD and NERD Patients after Laparoscopic Nissen Fundoplication.
INTRODUCTION: "Anatomic" or "organic" GERD is cured with antireflux Nissen fundoplication. Patients with symptom of "heartburn" but without erosive esophagitis or NERD are classified as "symptomatic GERD". In our experience the outcome of patients with GERD and patients with NERD following laparoscopic Nissen fundoplication (LNF) was quite different.METHODS: Since Jan1993, one of us (C.V.) has… Continue Reading
- Type:
- Posters
- Topic:
- Esophageal / Gastric Surgery
Direct Comparison of Different Techniques of Transgastric Access for NOTES Procedure
INTRODUCTION: Safe access to the peritoneal cavity is paramount for success of the NOTES procedures. We have recently described a PEG-like approach and pneumoperitoneum-assisted translumenal access to the peritoneal cavity. Aim of the study: Direct comparison of different transgastric access techniques in a live porcine model. METHODS: Fifteen experiments were performed on 50-kg pigs (Sus… Continue Reading
- Type:
- Posters
- Topic:
- Endolumenal / NOTES
Directed Submucosal Tunneling for Transgastric NOTES Procedures
Background: Prior natural orifice translumenal endoscopic surgery (NOTES) work has shown the feasibility and the advantages of obtaining peritoneal access by using a tunneled translumenal approach. Objective: We evaluated the feasibility of creating directed transgastric submucosal tunnels with the goal of positioning the endoscope in an in-line position with target abdominal locations. Methods: We obtained… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Endolumenal / NOTES
Do Hybrid Simulator-generated Metrics Correlate with Content Valid Outcome Measures?
Objective: Hybrid simulators provide objective metrics for laparoscopic task performance. The aim of this study was to evaluate the correlation between hybrid simulator-generated metrics and content valid outcome measures.Methods and Procedures: Residents underwent training with a previously validated 5-task simulation model (5-TSM). Tasks included: clip/divide vessel, excise lesion, loop appendectomy, mesh placement with tacks, and… Continue Reading
- Type:
- Podium Presentations
- Topic:
- Education / Simulation