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Surgical Leadership and Financial Stability through Strategic Growth

This study highlights the importance of financial stability for surgical leaders. It outlines key strategies employed over six years to increase revenue and manage expenses. By expanding faculty, advocating for more resources, and seeking external funding, the department raised revenue by 66%. While expenses also grew by 74%, leaders can potentially offset these by optimizing billing and increasing clinic capacity. The research emphasizes the complexity of financial stability, involving various stakeholders and interests, and the need for surgical leaders to master revenue and expense management.

Journal Article by Loftus TJ, McDowell LD and Upchurch GR in BMC Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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3D Printed Models Revolutionize Training for Complex Gastric Bypass Surgery

A cutting-edge training model for laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) has emerged, revolutionizing training for this intricate and high-risk procedure. Leveraging 3D printing technology, the models are designed to mimic the core surgical steps of LRYGB. The innovative use of fluorescent marking techniques allows for repeated practice, minimizing wear and tear. Unlike traditional methods that involve cadavers or expensive virtual reality simulations, these models offer a cost-effective, ethical, and highly realistic training platform for aspiring surgeons.

Editorial by Xia J, Mao J (…) Wang Z et 5 al. in Am J Surg

Copyright © 2023 Elsevier Inc. All rights reserved.

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Remote Surgical Robotic Training Boosts Skills for Medical Students

In a study involving 40 medical students new to surgical robotics, researchers compared two training methods: remote training via a multi-channel video system and traditional one-on-one guidance. The remote training group scored higher in specific exercises on a robotic simulator, suggesting its effectiveness for skill acquisition. Notably, the remote trainers reported less fatigue than their in-person counterparts. This study indicates that remote training systems have the potential to facilitate large-scale training in robotic surgery, providing an alternative approach for skill development.

Journal Article by Jiang L, Chen G (…) Wang X et 3 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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Diameter Trumps Volume in Monitoring High-Risk Thyroid Nodule Growth

In the evaluation of disease progression within high-risk thyroid nodules during active surveillance, researchers compared the effectiveness of tracking tumor diameter versus volume. Among 468 patients with a total of 569 high-risk thyroid nodules, only 2.5% showed a significant diameter increase of ≥3 mm, while volume fluctuations of 50% and 100% were noted in 32.5% and 15.1% of cases, respectively. The study conclusively suggests that tumor diameter measurement alone is a superior indicator for monitoring disease progression compared to volume, which proved less reliable.

Journal Article by Liu C, Zhao H (…) Li X et 10 al. in World J Surg

© 2023. The Author(s) under exclusive licence to Société Internationale de Chirurgie.

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Bariatric Surgery Boosts Physical Activity and Social Support

Bariatric surgery is a game-changer for physical activity (PA) and social support. In a Swedish study, adults undergoing metabolic and bariatric surgery (MBS) experienced significant improvements in PA levels, including light and total PA and step counts. Additionally, self-reported PA, enjoyment, self-efficacy for exercise, and positive family support all increased. While these gains didn’t lead to a significant rise in moderate to vigorous PA, they do hint at the potential for increased activity post-MBS, enhancing patients’ overall health and well-being.

Journal Article by Imhagen A, Karlsson J (…) Hagberg L et 3 al. in Obes Surg

© 2023. The Author(s).

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Antral Preservation in Sleeve Gastrectomy: A Game Changer for Gut Health

The debate on the optimal distance between the starting point of gastric transection and the pylorus in laparoscopic sleeve gastrectomy (LSG) remains unresolved. Some opt for a shorter distance to maximize weight loss, while others prefer a longer distance, believing it offers protection against post-surgery issues like vomiting and gastroesophageal reflux disease (GERD). This meta-analysis compared the outcomes of 6-cm and 2-cm distances from the pylorus, favoring the former due to its potential to reduce postoperative vomiting, GERD, and leaks.

Review by Diab AF, Kim A (…) DuCoin CG et 4 al. in Obes Surg

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

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TOETVA: Aesthetic Thyroid Surgery Learning Curve and Castle Tumor Case

The transoral endoscopic thyroidectomy vestibular approach (TOETVA) offers a cosmetic edge over traditional thyroid surgery. Researchers assessed TOETVA’s learning curve and its effectiveness in treating carcinoma showing thymus-like differentiation (CASTLE) tumors. The study found longer operation times in TOETVA, but it excelled in skin numbness and cosmetic outcomes. The learning curve analysis revealed that a surgeon becomes proficient in TOETVA after about 50 cases. Also, diagnosing CASTLE tumors is tricky, requiring specific markers. TOETVA is a viable option with safety and aesthetic advantages.

Journal Article by Jin X, Huang Z, Guo P and Yuan R in Langenbecks Arch Surg

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

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Predicting Postoperative Pneumonia in Esophageal Cancer Patients

Sarcopenia, a condition involving muscle loss, is common in esophageal cancer patients. This study delved into how sarcopenia, particularly during neoadjuvant chemotherapy (NAC), affects postoperative complications, especially postoperative pneumonia (PP). By analyzing 113 patients, they found that the criteria of the modified European Working Group on Sarcopenia in Older People (EWGSOP) before NAC had high sensitivity (100%) and reasonable specificity (75.8%) in predicting PP. Low body mass index and %vc before NAC were significantly linked to sarcopenia by the modified EWGSOP criteria. Ultimately, pre-NAC sarcopenia was a crucial predictor of postoperative pneumonia, suggesting the need for targeted interventions to prevent PP in these patients.

Journal Article by Nishi S, Miki Y (…) Maeda K et 8 al. in Dig Surg

© 2023 S. Karger AG, Basel.

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Optimal Inferior Mesenteric Artery Ligation in Colorectal Cancer Surgery

In colorectal cancer surgery, the debate about whether to perform high or low ligation of the inferior mesenteric artery (IMA) continues. This study compared the outcomes of both approaches and examined the extent of lymph node dissection of the IMA. The results, after matching patient groups, showed that high ligation was associated with better recurrence-free survival. However, it’s crucial to ensure thorough lymph node dissection even with high ligation. Positive IMA lymph nodes were linked to advanced cancer stages, and the location of IMA lymph node recurrences differed between the two ligation groups.

Journal Article by Nakamura Y, Yamaura T (…) Kuroda N et 6 al. in Dig Surg

© 2023 S. Karger AG, Basel.

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ERCP Vital in Managing Post-COVID-19 Cholangiopathy with Dismal Prognosis

Endoscopic findings reveal that post-COVID-19 cholangiopathy resembles secondary sclerosing cholangitis, affecting critically ill patients. It emerges early during intensive care, causing significant and often irreversible damage to bile ducts. Typical cholangiographic features include a centripetal pattern of bile duct destruction, “vanishing bile ducts,” and intraductal biliary casts. This condition is associated with peribiliary liver abscesses. The prognosis is grim, with a 1-year liver transplant-free survival rate of 44%. Endoscopic procedures, especially ERCP with cast removal, are invaluable for diagnosis, prognosis, and treatment.

Journal Article by Silke L, Donata G (…) Christian J et 11 al. in Am J Gastroenterol

Copyright © 2023 by The American College of Gastroenterology.

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