Very elderly patients (76-90) show comparable outcomes to younger counterparts after ventral hernia repair. No differences in 30-day mortality, readmissions, or complications. Very elderly patients reported higher quality of life scores at baseline and significant improvements at 30 days and 1 year. Surgeons can confidently include very elderly patients in surgical plans, as they achieve […]
Author: STITCHES Newsletter
Operating Room Communication Impacts Surgical Outcomes
Effective teamwork in the operating room significantly influences patient safety and surgical outcomes. Surgeons scored highest in teamwork and leadership, while circulating staff excelled in checklist completion and communication. Gender dynamics affected teamwork scores; male surgeons received lower ratings when their respondents were female. Longer surgeries (over 3 hours) correlated with lower teamwork and communication […]
Improving Resident Feedback in General Surgery Training
Increasing real-time feedback through entrustable professional activities (EPAs) enhances resident satisfaction during training. 74.4% of residents reported receiving at least one EPA microassessment per rotation. Satisfaction with feedback was significantly higher with more frequent EPA microassessments (p<0.001). On their worst rotations, satisfaction improved from 42% to over 50% when at least one EPA assessment was […]
Innovative Approach to SMA Dissection in Laparoscopic Surgery
A new in situ anterior technique for dissecting the superior mesenteric artery (SMA) during laparoscopic pancreaticoduodenectomy improves outcomes. Operative time averaged 340 minutes with a blood loss of 200 ml. Patient had no complications, including pancreatic fistula, and was discharged on postoperative day 8. This technique minimizes tension on mesenteric vessels, reducing the risk of […]
Surgical oncology training evolves to meet diverse needs
Recent survey shows how surgical oncology fellowship prepares graduates for varied practices with implications for patient selection and training focus. Post-2013 graduates feel better equipped for peritoneal surface and gynecologic cancers and robotic surgery. Pre-2013 graduates reported greater readiness for melanoma and thoracic cases. Consider emphasizing advanced training for emerging areas like robotic techniques and […]
Robotic Esophagectomy Cuts Nerve Palsy Risk, Outcomes Similar
Robot-assisted minimally invasive esophagectomy (RAMIE) shows lower nerve injury rates compared to conventional minimally invasive esophagectomy (MIE) for esophageal cancer. RAMIE had an operative time of 629 minutes vs. 574 minutes for MIE (p < 0.01). Incidence of recurrent laryngeal nerve (RLN) palsy was 22% with RAMIE vs. 34% with MIE (p = 0.02). Both […]
Robotic Single-Port Right Hepatectomy Shows Promise
Surgeons can safely perform robotic single-port right hepatectomy, offering a minimally invasive option for complex liver resections. The procedure took 241 minutes with minimal blood loss (100 ml) and no transfusions. The patient had negative resection margins and was discharged on postoperative day 7 without complications. This technique demonstrates feasibility and safety, suggesting it may […]
Phenotype-Specific Insights on Mortality After Pancreatoduodenectomy
The T-MOD PD framework identifies preventable mortality opportunities after pancreatoduodenectomy, crucial for improving surgical outcomes. 57% of deaths linked to postoperative pancreatic fistula (POPF), with 38% occurring in an early, surgery-related, modifiable context. 74% of deaths classified as surgery-attributable potentially preventable. Surgeons can target interventions based on identified phenotypes to enhance patient safety and outcomes. […]
International Benchmarks set for Robotic Whipple Surgery
Robotic Whipple surgery shows promising outcomes, establishing benchmarks vital for surgical practice. Conversion rate ≤4.3%, transfusion rate ≤2.1%, and 6-month mortality ≤2.2%. Major complications capped at ≤23.2%, with clinically relevant pancreatic fistula and hemorrhage rates ≤23.6% and ≤12.7%, respectively. These benchmarks can guide patient selection and enhance surgical quality. Higher caseload centers reported fewer pancreas-specific […]
Genetic and Lifestyle Factors Elevate Diverticulitis Risk
Surgeons should consider genetic and lifestyle factors to better stratify severe diverticulitis risk and optimize patient selection. High-risk individuals, based on polygenic and lifestyle scores, had a hazard ratio of 4.71 for severe diverticulitis, with a cumulative incidence of 3.50% versus 0.75% in lower-risk patients. The combined effects of genetic and lifestyle risks surpassed the […]