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Laparoscopy Packs Muscle Punch, Robotic Surgery Commands Cognitive Grit

In the epic battle of surgery techniques, researchers peek into surgeons’ minds and muscles during live laparoscopic and robotic surgeries. Surprise twist: laparoscopy flexes more muscle power, especially in the right-side troops. Meanwhile, the robotic realm demands more brainpower, with greater cognitive stress observed. It’s a showdown between muscle might and mental prowess, shaping the future battlefield of surgical methods.

Journal Article by Shugaba A, Subar DA (…) Gaffney CJ et 11 al. in Ann Surg Open

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Unmasking Doppler-Guided HAL: No Heroic Impact on Hemorrhoid Recurrence, Just Prolonged Surgery Time

In the battle against hemorrhoids, researchers dive into Doppler-guided hemorrhoidal artery ligation (DG-HAL) to see if it’s the superhero against recurrences. Spoiler alert: it’s not. In a cohort of 122 hemorrhoid warriors, DG-HAL didn’t cut recurrence risks, and to make things interesting, it actually extended surgery time. The quest for the ultimate hemorrhoid remedy continues, and DG-HAL might need a sidekick for better results.

Journal Article by Bonomo LD, Falletto E (…) Jannaci A et 2 al. in Ann Surg Open

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Unraveling Risks and Costs of Common Bile Duct Injury Post-Cholecystectomy in the U.S.

In the world of gallbladder adventures, a team unveils the secrets of common bile duct injury (CBDI) post-cholecystectomy in the U.S. Among 769,782 gallbladder enthusiasts, only 0.1% faced CBDI, linked to increased mortality risk. Biliary colic and obesity played guardian roles (lower risk), while pancreas disease and chronic liver disease spiked risks. Same-day CBDI repair scored lowest costs, with the highest bills for repairs within 1-3 months. Even with improvements, CBDI remains a perilous gallbladder aftermath, demanding continued scrutiny.

Journal Article by Elser H, Bergquist JR, Li AY and Visser BC in Ann Surg Open

Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.

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Synthetic Mesh Holds Its Ground: Comparable Efficacy and Safety in Preventing Incisional Hernias Post Ileostomy Closure

In the Preloop trial, 97 patients underwent loop ileostomy closure with either retrorectus synthetic or biological mesh. Results at 10 months showed comparable outcomes—2% incisional hernia rates in both groups, and no significant differences in complications, reoperation rates, or hospital stay. The findings suggest synthetic mesh’s efficacy and safety match up to its biological counterpart, challenging the notion of avoiding synthetics in contaminated surgical sites. A mesh choice dilemma resolved for surgeons in the quest to prevent incisional hernias.

Journal Article by Mäkäräinen EJ, Wiik HT (…) Rautio TT et 7 al. in Br J Surg

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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HIPEC Consensus: Dutch Protocol Prevails for Colorectal Cancer Peritoneal Metastases

Global Experts Agree: In treating colorectal cancer with peritoneal metastases, cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC) extends median overall survival beyond 40 months. The consensus among 78% of international panelists highlights the conditionally recommended use of HIPEC post-surgery. The Dutch protocol, featuring mitomycin-C, gains preference over the short, high-dose oxaliplatin regimen. Despite weak evidence, the study establishes guidelines for HIPEC regimens, urging ongoing research for further optimization.

Journal Article by Hübner M, van Der Speeten K (…) Glehen O et 4 al. in Ann Surg Oncol

© 2023. The Author(s).

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Certified Colorectal Surgeons Transform the Game: Reduced Mortality and Leaks in Laparoscopic Resections

Certified colorectal surgeons shine in laparoscopic low anterior resections! A study with 41,741 patients in Japan found colorectal-specific certified surgeons significantly lowered 30-day mortality (0.2%) and anastomotic leak rates (9.3%) compared to noncertified peers, especially those with biliary certification. The bottom line? When it comes to these surgeries, having a colorectal-certified surgeon on the team substantially reduces risks, ensuring smoother outcomes.

Journal Article by Yamaguchi S, Endo H (…) Sakai Y et 8 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Post-Surgery Employment: Japanese Colorectal Cancer Patients Achieve 79% Return Rate in 12 Months

Japanese colorectal cancer patients (stages I-III) witnessed promising employment outcomes within 12 months post-surgery, with a 79% return-to-work rate. The study identified risks for delayed return, including advanced tumor stage, stoma presence, severe complications, shorter work tenure, and lower return-to-work inclination. Factors contributing to unemployment at 12 months included stoma, reluctance to return, nonregular employment, lower income, national health insurance, and lack of private medical coverage. Results encourage healthcare providers to support patients in considering post-surgery work reintegration.

Journal Article by Fujita Y, Hida K (…) Obama K et 7 al. in Dis Colon Rectum

Copyright © The ASCRS 2023.

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Hernia Center Labels: No Clear Edge in Ventral Hernia Repair Outcomes

In the quest for superior hernia care, researchers explored designated hernia centers (DHCs). Analyzing over 14,000 ventral hernia repairs (VHRs) from 261 sites, they found no clear advantage to DHCs. Surprisingly, non-designated hernia centers (NDHCs) displayed fewer 30-day complications and lower one-year hernia recurrence rates. The message? Current hernia center labels might not guarantee better outcomes, urging a need for standardized criteria to truly enhance hernia care value in the United States.

Journal Article by Haskins IN, Huang LC (…) Perez AJ et 2 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Irreversible Nerve Damage: The Pre-op Pain Predictor for Chronic Post-op Pain in Inguinal Hernia Patients

Inguinal hernia patients with pre-op pain face potential irreversible nerve damage, signaling a road to chronic post-op pain (CPIP). Studying 40 patients who underwent hernia repair, researchers found intraneural fibrosis within the ilioinguinal nerve in all pre-op pain cases. The fibrosis degree correlated positively with pain duration. This unveils a crucial link between pre-op pain and lasting nerve injury, shedding light on the mysterious path to CPIP.

Journal Article by Narita M, Moriyoshi K (…) Hata H et 9 al. in Langenbecks Arch Surg

© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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Subtotal vs. Total Adrenalectomy in Bilateral Pheochromocytoma – Less Insufficiency, More Recurrence?

In the world of adrenal gland dilemmas, researchers delve into the showdown between total adrenalectomy and its hip sibling, subtotal adrenalectomy, for bilateral pheochromocytoma. Analyzing 10 studies with 1202 patients, they uncover that subtotal adrenalectomy, while saving from adrenal insufficiency, packs a punch with a higher recurrence rate (14.1% vs. 2.6%) and lower post-surgery steroid dependence (93.3% vs. 11.6%). Future battles call for randomized studies to confirm these adrenal wrestling outcomes.

Journal Article by Schiavone D, Ballo M (…) Iacobone M et 4 al. in BJS Open

© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd.

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