Surgical research in African low- and middle-income countries faces ethical challenges due to diverse socio-economic and cultural contexts. A comprehensive review highlights issues like informed consent and community engagement. Recommendations include organized workshops and training for local researchers to navigate these challenges. By prioritizing ethical standards, the potential of surgical research to enhance healthcare delivery […]
Category: Perspectives, Opinions and Curiosities
Indocyanine green imaging outperforms traditional methods for lymph node assessment
A study highlights the superior efficacy of indocyanine green (ICG) fluorescence imaging over conventional nanocarbon dyes in detecting peri-intestinal lymph node metastasis in colorectal cancer patients. The research analyzed 30 cases, revealing significant correlations between fluorescence intensity and metastasis presence. Among 243 lymph nodes, 18 metastatic cases were identified, with ICG fluorescence showing strong association […]
Robotic liver surgery shows manageable learning curves for surgeons
Evaluation of robotic liver resections at San Raffaele Hospital revealed effective learning curves for two surgeons with varied laparoscopic experience. The pioneer surgeon achieved proficiency in high-complexity cases after 10 cases, while the new generation surgeon required 18. Operative times improved significantly for both after completing 15 low and 10 intermediate cases, demonstrating the impact […]
High Rate of Adverse Events Found in South African Surgical Service
In a comprehensive analysis of a decade’s worth of data from a tertiary surgical service in South Africa, researchers documented a notable 22% adverse event rate among 52,835 admissions. A total of 14,537 adverse events were identified, primarily linked to clinical care (57.3%) and pathology (21.4%). Indwelling devices and iatrogenic injuries were the most common […]
Surgeons’ dual roles face unprecedented decline
The decline of surgeon-scientists has reached critical levels, with their unique contributions to research and patient care in jeopardy. A systematic review and global survey revealed gaps in applying existing countermeasures to address this issue. Key reasons identified include a profit-driven focus in hospitals and a flawed selection process for academic excellence. Researchers propose a […]
Standardization of Surgical Complication Reporting Promoted
A recent study evaluated the use of the Clavien-Dindo Classification (CDC) and Comprehensive Complication Index (CCI) in assessing postoperative morbidity across randomized controlled trials (RCTs). Although reliance on these metrics is growing, only one-third of RCTs adequately utilized the complete spectrum of CDC grades. The findings were enriched by input from 163 surgeons on complex […]
Robotic training effectiveness varies by prior surgical experience
In an evaluation of robotic surgical training, participants—including experienced robotic surgeons, laparoscopic surgeons, and novices—demonstrated varying skill levels across first-touch tasks. Robotic surgeons outperformed both laparoscopic surgeons and novices in pegboard and camera operations. It was observed that prior experience notably influenced first-touch skills, while overall surgical experience affected suturing performance. These findings emphasize the […]
Delaying elective surgery post-NSTEMI improves patient outcomes
The analysis of Medicare claims data from over five million surgeries indicated that older patients who had a nonST-elevation myocardial infarction (NSTEMI) within 30 days faced significantly higher odds of major adverse cardiovascular events (MACCE). In contrast, those with previous revascularization showed improved outcomes when surgery was postponed to 90-180 days post-NSTEMI. The findings advocate […]
Powered staplers improve surgical outcomes and reduce costs
A systematic review involving 43,104 patients demonstrates that powered staplers significantly reduce anastomotic leaks in gastrointestinal surgeries and postoperative air leakage in thoracic surgeries. The use of powered staplers also led to fewer hemostasis-related complications and decreased overall hospitalization costs, showing a mean savings of $1,725.82. While powered staplers are more expensive upfront than manual […]
Reinforced tension-line suture reduces incisional hernia rates.
The addition of a reinforced tension-line (rtl) suture during fascial closure significantly decreased the incidence of incisional hernia after elective colorectal cancer surgery. In a trial involving 134 participants, 6% of patients in the rtl group developed hernias compared to 21% in the standard suture group, marking a substantial reduction (p = 0.014). No unintended […]