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Dilation Status Irrelevant in Bile Duct Injury Repairs: Surgical and Radiological Drainages Equally Effective

A retrospective study on 87 patients who underwent hepaticojejunostomy (HJ) for bile duct injuries (BDI) aimed to determine whether the dilation status of the bile duct before repair affected outcomes. The study found that dilation status had no impact on short- or long-term results, including anastomotic stricture rates. Patients without preoperative dilation had more severe BDI injuries and lower rates of preoperative cholangitis. The study suggests that both surgical and radiological external biliary drainages can effectively reduce cholangitis risk without increasing the risk of long-term anastomotic stricture.

Journal Article by Marichez A, Fernandez B (…) Chiche L et 7 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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Remote Assessment of Surgical Safety Checklists

Researchers utilized the OR Black Box, a surgical data capture system, to evaluate surgical safety checklist performance across 7 North American academic medical centers. Their analysis of 7,243 surgical procedures revealed that most included a time-out (98.4%) and 62.3% included a debrief. These procedures often involved a majority of OR staff, with team introductions leading to more checklist items completed, higher engagement, and better focus during time-outs. This remote assessment offers valuable insights and the potential to enhance intraoperative processes.

Journal Article by Riley MS, Etheridge J (…) Molina G et 7 al. in J Am Coll Surg

Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.

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How Condition Timing Impacts Liver Surgery Outcomes

In the realm of liver surgery, understanding the “condition(s) present at time of surgery” (PATOS) from the American College of Surgeons (ACS) database is crucial. Researchers explored postoperative complications, considering PATOS, and found that when these conditions were factored in, complication rates dropped across the board. Their study, covering data from 2015 to 2019, highlights the significance of accounting for PATOS in assessing post-surgery complications in liver patients. This data-driven approach can lead to better-informed surgical decision-making and improved patient outcomes.

Journal Article by Jehan FS, Ganguli S (…) Aziz H et 4 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Conversion to Open Surgery in Liver Resection: Risks and Consequences

Researchers delved into minimally invasive liver resections (MILR) and what happens when they switch to open procedures. Out of 1,675 patients, 6.1% required a switch due to unfavorable findings or intraoperative issues. Those needing a conversion experienced higher complications, blood loss, and mortality. Intraoperative conversions had even worse outcomes, emphasizing the need for cautious planning and early conversion for high-risk patients. This study warns about the challenges of transitioning from MILR to open surgery, highlighting the associated risks and complexities.

Journal Article by Gudmundsdottir H, Fiorentini G (…) Cleary SP et 14 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Surgical Tele-Mentoring Enhances Robotic Surgery

This study explored the impact of surgical tele-mentoring, where remote experts guide local surgeons via robotic technology. They conducted a feasibility study in fields like general, urology, gynecology, and thoracic surgery, with 15 cases. The results were impressive; participants reported enhanced procedural competence, timely interventions, improved surgical efficiency, and better decision-making. Connectivity remained robust with no perceived delays. This technology was deemed safe and valuable, showing great promise in expanding access to surgical expertise during peacetime, wartime, and pandemics.

Journal Article by Faris H, Harfouche C, Bandle J and Wisbach G in Surg Endosc

© 2023. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.

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Endoscopic Resection for Duodenal Tumors: What to Watch For

A study on 141 patients with duodenal submucosal tumors (SMTs) explored the outcomes of endoscopic resection (ER). Results showed that 78.7% achieved complete resection, but 6.4% faced complications. High-risk factors for complications included SMTs near the duodenal papilla and those with a diameter exceeding 15mm. Additionally, submucosal fibrosis, SMTs near the duodenal papilla, and irregular morphology were found to be risk factors for incomplete resection. Despite challenges, ER can be an effective and minimally invasive treatment for duodenal SMTs, but careful consideration of these factors is essential.

Journal Article by Geng ZH, Zhu Y (…) Li QL et 4 al. in Surg Endosc

© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Pregnant Surgeons’ Musculoskeletal Pain

The study delves into work-related musculoskeletal disorders (WRMD) among pregnant surgeons, an understudied area. Surveying 53 pregnant surgeons, it revealed that almost all of them (94.7%) experienced an exacerbation of WRMD symptoms due to workplace activities. Over 13% had to take unplanned time off work. Strikingly, beyond 24 weeks of pregnancy, a majority continued surgeries, extended shifts, and heavy lifting, and no institutional pregnancy-specific surgical ergonomics policies were in place. These findings emphasize the need for attention to surgical ergonomics during pregnancy and institutional policy development.

Journal Article by Wang CN, Shah M (…) Badalato GM et 5 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Comparing Open and Laparoscopic Surgery for Hernia Repair

In the INCH-trial, researchers conducted a multicenter randomized controlled trial comparing open and laparoscopic surgery for incisional hernia repair. They initially believed laparoscopic surgery would offer advantages, but after studying 88 patients, found no significant differences in hospital stay, quality of life, or recurrence rates. Dissatisfaction was higher in the open surgery group. These results suggest that individualized surgical management and patient expectation management are crucial in hernia repair, despite the global popularity of laparoscopic techniques.

Journal Article by van Veenendaal N, Poelman M (…) Bonjer J et 5 al. in Surg Endosc

© 2023. The Author(s).

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Patient Perspectives on Surgical Prehabilitation: Unveiling Adherence Challenges and Motivational Factors

Understanding why patients might not fully engage in pre-surgery prehabilitation programs is vital. In a study connected to the “Perioperative Optimization with Enhanced Recovery” (POWER) trial, barriers and motivators to prehabilitation adherence were examined. While common barriers included health issues and lack of motivation, these didn’t significantly affect exercise adherence. However, higher barriers to healthy eating were linked to lower Mediterranean diet scores. Interviews highlighted that prehabilitation motivated healthier choices through goal setting and efficient workouts, illuminating areas for improved prehabilitation programs.

Journal Article by Kimura C, Liu Y (…) Kin C et 6 al. in J Gastrointest Surg

© 2023. The Society for Surgery of the Alimentary Tract.

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Mapping Review Reveals Strategies for Reducing Pain in Chronic Wound Dressing Changes

This mapping review addresses a pressing issue: pain during chronic wound dressing changes. Existing UK guidelines prioritize wound healing over pain management during these procedures. The review aims to gather, assess, and describe current research on strategies for assessing and reducing pain during chronic wound dressing changes. By sifting through the available evidence, it seeks to pave the way for updated guidance that addresses pain as a primary concern for patients, caregivers, and healthcare professionals.

Journal Article by Kirkcaldy AJ, Wilson M (…) Campbell F et 2 al. in BMJ Open

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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