Longer operative time is associated with higher odds of major complications and prolonged postoperative stay in minimally invasive esophagectomy. The relationship between operative time and achieving textbook outcome (TO) is characterized by an inverse U-shaped correlation, with a significant peak at 298 minutes. Prolonged operative time may indicate targets for quality improvement and risk adjustment […]
Category: General Surgery
Improved Intraoperative ICGFA Guidance for Bowel Transection
A novel patient-calibrated quantitative ICGFA method was developed to recommend optimal bowel transection sites during surgery, showing 85% agreement with baseline perfusion. The software successfully identified expert surgical transection sites in almost all cases, reducing the risk of anastomotic complications. High-resolution augmented reality heatmaps were generated for guidance, integrating seamlessly into existing clinical workflow and […]
Magnetic Compression Anastomosis: A Sutureless Alternative for Superior Gastrointestinal Outcomes
Magnetic compression anastomosis (MCA) offers sutureless passage construction for tubular organs, showing promise due to low recurrence rates and improved clinical outcomes compared to conventional treatments. The review highlights MCA’s use in various gastrointestinal diseases, showcasing superior anastomotic results compared to surgical sutures. Although initial studies demonstrate safety and feasibility, larger prospective studies are needed […]
Impact of high-volume low complexity Surgical Hubs on elective surgery backlog
Utilizing a mixed methods approach, the MEASURE study aims to evaluate the productivity, patient care, and workforce impact of the high-volume low complexity surgical hubs programme on the backlog of elective surgery patients in England. The study, informed by the consolidated framework for implementation research, involves six interlinked work packages and has received ethics approval. […]
Higher Attrition Rates in Placebo-Controlled Surgical Trials
Placebo-controlled surgical trials showed similar recruitment but significantly higher attrition compared to non-operative trials. Incorporating additional follow-up timepoints can reduce attrition rates in placebo-controlled studies. Researchers should consider strategies to mitigate dropout and loss to follow-up in surgical trials with placebo controls. Journal Article by Natarajan P, Menounos S (…) Adie S et 7 al. […]
Rectal Cancer Guidelines: Inconsistent Reporting Quality Raises Concerns about Transparency and Evidence Use
Clinical practice guidelines for rectal cancer vary in reporting quality, with unique weaknesses in basic information, evidence, recommendations, and review processes. Common themes include limited financial discussion and lack of transparency. Even with variability, current guidelines meet most checklist elements, highlighting the importance of high-quality reporting standards for expert guideline creation. Journal Article by Cai […]
Malpractice Claims Following Major Liver and Pancreatic Surgeries
General surgery is a highly litigious specialty, with most claims related to delays in diagnosis or surgical negligence. A study analyzing malpractice cases from the last two decades found that the majority named surgeons as defendants, with a higher likelihood of verdicts favoring defendants. Payouts to plaintiffs, though less common, were significant, highlighting the legal […]
Endoscopic bariatric and metabolic therapies for obesity: ASGE-ESGE guideline
The joint American Society for Gastrointestinal Endoscopy-European Society of Gastrointestinal Endoscopy (ASGE-ESGE) guideline provides evidence-based recommendations for endoscopic bariatric and metabolic therapies (EBMTs) in treating obesity. Using the GRADE framework, the guideline evaluates the efficacy and safety of EBMT devices and procedures with CE Mark or FDA clearance/approval. It recommends EBMTs plus lifestyle modification for […]
Hidden Port Site Incision for Robotic Foregut and Hepatopancreatobiliary Operation
Developed to minimize visible scars on the abdomen, the hidden port site incision technique at the pubic hairline offers a cosmetically superior approach for common foregut and hepatopancreatobiliary procedures. This technique maximizes cosmetic outcomes while maintaining clinical efficacy, especially beneficial for patients with poor healing or scarring tendencies. Journal Article by Fefferman ML, Zheng C, […]
Predictors of Non-operative Treatment Failure in Patients with Acute Diverticulitis and Abscess
The study identified independent predictors of failure in non-operative treatment for patients with diverticular abscesses, highlighting the significant role of Hinchey classification, tobacco smoking, and abscess characteristics. Percutaneous drainage did not impact treatment success in larger abscesses. This underscores the need for targeted interventions in diverticular disease management, particularly for high-risk patient groups. Journal Article […]