Children with equivocal appendicitis are often unnecessarily admitted, leading to high rates of negative appendectomies. 54% of patients were admitted for observation after-hours, with 30% undergoing unnecessary appendectomies. An Alvarado score under 5 accurately ruled out appendicitis in all cases, yet 44% of these low-score patients were still admitted. Discharging children with low Alvarado scores […]
Category: Appendix, Gallbladder and Surgical Emergencies
Maximizing Efficiency in Robotic Cholecystectomy
A new service evaluation reveals that implementing high-intensity theatre (HIT) principles can double productivity for robotic cholecystectomy. Up to 10 robotic cholecystectomies can be performed in a single day, compared to 5 laparoscopic cases. Theatre utilization increased by 100%, optimizing patient throughput and revenue potential. This approach could significantly reduce elective surgery waiting lists while […]
Next-gen camera control for cholecystectomy using mixed reality
A new head-mounted mixed reality platform could revolutionize cholecystectomy by improving camera control. Verbal instructions for camera assistants dropped from 15.3 to 0.2 per procedure. Mean operative time decreased from 74.8 to 66.0 minutes. This technology not only boosts efficiency but also enhances visualization and reliability in surgery. Camera movements were reduced by over 70%, […]
Optimal Timing for Surgery in Small Bowel Obstruction
Early surgical intervention in small bowel obstruction can significantly reduce mortality and improve outcomes. Surgery within 24 hours cut mortality risk by 47% (risk ratio 0.53). Analysis included 47 studies with 12,486 patients, providing robust data on outcomes. Implementing earlier interventions could be critical for improving patient survival and minimizing complications. Delaying surgery past 24 […]
Interhospital Transfers in Acute Mesenteric Ischemia Raise Risks
Delayed care due to interhospital transfers significantly increases mortality and procedural severity in acute mesenteric ischemia. Of 39,690 AMI hospitalizations, 14.6% involved transfer, which correlated with higher complication rates. Transferred patients had 3.48 times the odds of bowel resection and 2.05 times higher in-hospital mortality after adjustments for age and comorbidities. Early diagnosis and streamlined […]
AI Enhances Scar Detection in Laparoscopic Cholecystectomy
An AI framework improves scar tissue visualization during laparoscopic cholecystectomy under bleeding conditions, which is critical for preventing bile duct injuries. The system significantly improved scar detection, yielding a p-value < 0.001 across expert surgeons. It translates bleeding images into clearer representations for better surgical decision-making. Surgeons can utilize this real-time technology to enhance safety […]
Outpatient Protocol Cuts Hospital Stay for Diverticulitis Patients
Outpatient management of uncomplicated left-sided diverticulitis significantly reduces length of stay without increasing readmissions. Length of stay in the outpatient group was 29.7 hours shorter than inpatient care (p < 0.001). Co-morbid patients (ASA 3 and 4) faced a stay increase of 17 hours (53 hours vs. 35 hours, p < 0.001). Consider implementing an […]
New Insights on Appendicitis Treatment Options
Endoscopic retrograde appendicitis therapy (ERAT) could reduce complications in select patients with uncomplicated appendicitis. ERAT has a complication rate of only 6.3%, significantly lower than antibiotics at 37.8%. Appendectomy remains the best for preventing recurrence (recurrence rate 0.6% vs. 53.2% for ERAT and 2.2% for antibiotics). ERAT might be a safe alternative for specific patients […]
Early ERCP cuts mortality in acute cholangitis from CBD stones.
Urgent ERCP (within 24 hours) significantly reduced in-hospital mortality to 0.5% compared to 21% for non-urgent (adjusted OR 0.09; p=0.024). Median hospital stay was shorter with urgent ERCP (5 days vs 8 days; p<0.001). Surgeons should prioritize early ERCP for moderate to severe cases to improve outcomes. Mortality benefits were pronounced in moderate and severe […]
Older Adults at Higher Risk Post-Hollow Viscus Injury
Older adults (65+) decompensate rapidly after blunt hollow viscus injuries, affecting surgical outcomes. Mortality odds for older adults undergoing surgery are eight times higher than for younger adults. Older adults wait nearly double the time to surgery compared to younger patients. Delays over one hour from admission to surgery significantly increase mortality risk. After 48 […]