A comprehensive study across 17 centers on four continents, comparing robotic bariatric surgery with laparoscopic benchmarks, involved 9,097 patients. In expert centers, robotic Roux-en-Y gastric bypass demonstrated lower benchmark cut-offs for hospital stay, bleeding, and ulceration but had a longer operation duration. Robotic sleeve gastrectomy outperformed its laparoscopic counterpart in most outcomes. Overall, newly established […]
Category: General Surgery
Combined Hepatocholangiocarcinoma: Worse Survival Than Hepatocellular Carcinoma, Similar to Intrahepatic Cholangiocarcinoma
In a retrospective study of 3,196 surgery-treated patients with combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma, survival outcomes were analyzed. Despite data limitations, overall survival for combined hepatocholangiocarcinoma was worse than hepatocellular carcinoma but similar to intrahepatic cholangiocarcinoma. Disease-free survival was comparable among the three groups. Predictors of mortality included the cancer subtype, metabolic syndrome, […]
Appendectomy vs. Hemicolectomy for 1- to 2-cm Appendix Neuroendocrine Tumors: A Survival Analysis
Examining 3,189 patients with 1- to 2-cm neuroendocrine tumors of the appendix, researchers found that while the appendectomy rate increased over the years, it wasn’t linked to improved survival compared to right hemicolectomy. Grade 2 and 3 tumors were associated with a lower likelihood of appendectomy. Despite differences in tumor grades and patient travel distance, […]
Prophylactic Negative Pressure Wound Therapy in Emergency Laparotomy: No Significant Reduction in Surgical Site Infections
Examining 65,803 emergency laparotomy patients, researchers found no significant difference in surgical site infection (SSI) rates when comparing prophylactic negative pressure wound therapy (NPWT) to standard dressings. Propensity-matched cohorts with completely or partially closed incisions showed similar SSI rates (13.4% vs. 11.9% and 3.6% vs. 4.4%, respectively). Secondary outcomes, including postoperative complications and hospital length […]
Objective Hiatal Hernia Sizing: Enhancing Precision in Surgical Decision-Making
Investigating hiatal hernia (HH) size reporting, researchers compared subjective estimates with objective axial length measurements in 93 patients. While endoscopic subjective size allocations correlated with intra-operative decisions, axial length measurements significantly correlated with manometry results. Only one barium swallow report included an objective HH size measurement. Integrating axial length measurements into endoscopy reports is crucial, […]
Mitigating Laparoscopic Gas Leaks: A Clinical Trial with Optical Imaging and a Novel Vacuum-Ring Device
In a clinical trial, researchers utilized optical gas imaging to detect laparoscopic gas leaks during surgeries and tested a vacuum-ring device’s effectiveness in mitigating leaks. Among 1643 trocar instrumentations, leaks occurred in 62.6% of visualized instances. The intervention group, using the vacuum-ring device, showed a significant reduction in high-energy leaks (Class 3) compared to the […]
Mentorship-Based Clerkship Boosts Student Confidence and Interest
A Mentorship-Based Surgery Clerkship (MBSC) significantly enhances medical students’ surgical experiences, confidence, and perceptions. In a nonrandomized trial with 84 participants, MBSC students reported increased confidence in surgical skills, positive perceptions of surgeons, and greater interest in pursuing surgery compared to the non-mentored group. The innovative program positively impacted students’ perceived meaningfulness, surgeon qualities, and […]
US Hepatopancreatobiliary Surgeon Supply Surpasses Demand
Examining 1998-2019 data, this study unveils a potential surplus in the supply of hepatopancreatobiliary (HPB) surgeons in the US. In 2019, 37,335 inpatient HPB procedures occurred, with an estimated 905-1191 practicing HPB surgeons. Factoring in centralization and volume-outcome benchmarks, the study projects a possible oversupply by 2030. Without adjustments, the data suggests a risk of […]
Advancing Rectal Cancer Care: Safe Implementation of a Stent-Assisted Ileal Bypass
In a study spanning January 2022 to January 2023, researchers explored the safety and viability of a pioneering stent-assisted ileal bypass for individuals undergoing sphincter-preserving surgery for rectal cancer. With 11 successful cases, the innovative approach, involving a biofragmentable ileal stent and diversion tube, proved safe and feasible. Results indicated potential benefits, including the avoidance […]
Laparoscopic Liver Tunnel for Hepatocaval Confluence Tumors
Researchers present a groundbreaking laparoscopic liver tunnel technique for tumors at the hepatocaval confluence, expanding parenchyma-sparing surgery possibilities. A case study involving synchronous colorectal liver metastases demonstrates the feasibility of this approach, allowing resection of ill-located tumors with complex vascular relationships through minimally invasive means. The method significantly enhances the scope of liver surgery, particularly […]