Robotic pancreatoduodenectomy (rpd) can reduce pancreatic fistula risk but may increase post-pancreatectomy hemorrhage (pph) risk. Among 1,925 patients, rpd led to 4.8% ppf vs. 9.3% in open procedures (opd). rpd had an increased pph risk (odds ratio 1.63) compared to opd. Patients with a pancreatic fistula faced a 3.97 times higher chance of pph, particularly […]
Author: STITCHES Newsletter
Bridging Residency to Vascular Fellowship: Key Competencies Mapped
Early alignment of residency and fellowship milestones can predict surgical trainee success. Significant alignment found between PGY-5 general surgery and year-1 vascular surgery fellowship competencies in professionalism, patient care, medical knowledge, and interpersonal skills. For every 1-unit difference in residency milestones, fellows showed mean differences of 0.49 to 0.64 units in competencies. These insights can […]
New tool predicts long-term recovery outcomes in surgery
A new risk calculator helps surgeons predict protracted recovery and long-term loss of independence in veterans post-surgery. Care assessment needs score for 90-day hospitalization and pre-op functional status are the strongest predictors. The model shows high accuracy (c-statistics 0.906-0.908) with 83% sensitivity and 82% specificity. Surgeons can use this tool to identify high-risk patients for […]
AI Enhances Aneurysm Detection in Surgery
AI assistance significantly boosts detection of cerebral aneurysms during surgery, a game-changer for surgical practice. Health care professionals achieved 78% accuracy with AI vs. 70% without it (odds ratio: 1.77, p < 0.001). Neurosurgical attendings improved from 77% to 92% accuracy with AI support (odds ratio: 4.24, p = 0.003). AI is not just for […]
Robotic Groin Hernia Repair Linked to Higher Recurrence Rate
Robotic-assisted groin hernia repair shows higher long-term recurrence than laparoscopic or open methods, raising questions about its value. 5-year recurrence rates: robotic 3.78%, open 3.37%, laparoscopic 3.21%. Laparoscopic repairs significantly reduce recurrence compared to open surgery (hazard ratio 0.75). Surgeons should weigh the recurrence rates when considering robotic assistance for hernia repairs. Robotic procedures increased […]
Guidelines on Hemorrhoid Management for Surgeons
Surgeons should prioritize conservative treatment options for hemorrhoids, reserving surgery for severe cases. Rubber band ligation and infrared coagulation are effective first-line treatments for grades 1-3 hemorrhoids. Surgical intervention is mandated for acute thrombosed hemorrhoids and grade 4 internal hemorrhoids. Patients with inflammatory bowel diseases should only undergo management after achieving remission to prevent complications. […]
Evolving the Evidence in Global Surgery
A shift in global surgery is needed to address current challenges in evidence generation and care delivery. Traditional research methods are inadequate for sustainability and equity in surgical practices. Emphasizing context-sensitive and systems-oriented approaches is critical. Strengthening foundational evidence will enhance credibility and guide effective policy and surgical decisions. Future success depends on both expanding […]
Using Language Models for Surgical Consensus: Key Findings
Large language models may enhance consensus-building on ventral rectopexy but vary significantly in reliability. Openevidence had the highest content appropriateness score (3.5/5), outperforming Gemini (3.0/5) and ChatGPT (2.8/5; p < 0.001). ChatGPT fabricated 53% of citations compared to Gemini’s 12% and Openevidence’s 0% (p < 0.001). This suggests a need for careful selection of tools […]
Roux-en-Y Gastric Bypass Reversal Insights for Surgeons
Roux-en-Y gastric bypass (RYGB) reversal is rare but offers significant symptom relief for select patients with complications. 199 patients underwent RYGB reversal over 16 years, 0.3% of 63,797 RYGBs. 86% reported symptom relief; highest in those with postbariatric hypoglycemia (94.6%). Complications are common: 24.6% had early severe complications, 21.6% experienced late complications. Careful patient selection […]
Predicting Days at Home after GI Cancer Surgery with HOMEDAYS
A new prediction model helps surgeons estimate patient recovery time after gastrointestinal cancer surgery, improving preoperative counseling. Among 91,270 patients, the median days at home within 90 days post-surgery was 82 (IQR 77-85). The model achieved strong accuracy (mean absolute error 8.67) and good calibration. This tool enhances shared decision-making by providing tailored recovery expectations […]