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South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie

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https://www.readbyqxmd.com/read/29227056/the-value-of-supplementary-anatomy-workshops-for-improving-undergraduate-performance
#1
J Scott, G Louw, D Kahn
BACKGROUND: With many anatomy courses within the medical curriculum suffering reductions in lecture and dissection time, supplementary programs in anatomy have shown to improve performance of medical students. This study was conducted to evaluate the efficacy of anatomy workshops on undergraduate anatomy grade performance. METHOD: From 2012 to 2014, mean anatomy and physiology scores of medical students who attended anatomy workshops were compared to those who did not attend...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227055/does-the-reporting-of-gastro-intestinal-endoscopy-meet-the-minimal-terminology-standard-at-king-edward-viii-hospital
#2
S P Maharaj, M A Noorbhai, T E Madiba
BACKGROUND: The Minimal Standard Terminology (MST) was developed to standardise endoscopic reporting. This study is aimed at assessing current reporting at a tertiary hospital and whether it meets this Minimal Standard Terminology. METHOD: This was a retrospective observational study of upper endoscopy reports between January and December 2014. The data extracted were compared to the current reporting standard listed in the MST. To assess and grade the quality of reporting we developed a Gastrointestinal Reporting Score, which incorporates MST variables in addition to demographic details, indication for endoscopy, report legibility, sedation and the use of classification systems to describe pathology...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227054/auditing-surgical-service-provision-at-a-south-african-tertiary-institution-implications-for-the-development-of-district-services
#3
G L Laing, D L Skinner, J L Bruce, C Aldous, V Govindasamy, S R Thomson, D L Clarke
BACKGROUND: The optimal management of resources within South African state hospitals has been hampered by a paucity of data due to a lack of robust auditing information systems. This study reviews the use of a Hybrid Electronic Medical Record (HEMR) system to capture and aggregate data pertaining to the inpatient service demands on a South African tertiary surgical service. This dataset was used to analyse the appropriateness of tertiary surgical resource utilisation. METHOD: The HEMR system was implemented at Greys Hospital, in the city of Pietermaritzburg, Kwa-Zulu Natal, South Africa on 1 January 2013...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227053/quantifying-the-funding-gap-for-management-of-traumatic-brain-injury-at-a-major-trauma-centre-in-south-africa
#4
V Y Kong, J J Odendaal, J L Bruce, G L Laing, E Jerome, B Sartorius, P Brysiewicz, D L Clarke
BACKGROUND: Trauma is an eminently preventable disease. However, prevention programs divert resources away from other priorities. Costing trauma related diseases helps policy makers to make decisions on re-source allocation. We used data from a prospective digital trauma registry to cost Traumatic Brain Injury (TBI) at our institution over a two-year period and to estimate the funding gap that exists in the care of TBI. METHOD: All patients who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI were identified from the Hybrid Electronic Medical Registry (HMER)...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227052/laparoscopy-or-clinical-follow-up-to-detect-occult-diaphragm-injuries-following-left-sided-thoracoabdominal-stab-wounds-a-pilot-randomized-controlled-trial
#5
G F Malherbe, P H Navsaria, A J Nicol, S Edu, S Chowdhury
BACKGROUND: The purpose of this study was to determine whether patients with left-sided thoracoabdominal (TA) stab wounds can be safely treated with clinical and chest X-ray follow up. METHOD: A prospective, randomized control study was conducted at Groote Schuur Hospital from September 2009 through to November 2014. Patients with asymptomatic left TA stab wounds included in the trial were randomized into two groups. Group A underwent diagnostic laparoscopy and Group B underwent clinical and radiological follow-up...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227051/serum-alcohol-levels-correlate-with-injury-severity-and-resource-utilization
#6
A I Elshiere, M A Noorbhai, T E Madiba
BACKGROUND: Alcohol consumption leads to violence and poor judgement. The resultant trauma is the leading cause of emergency department visits. In South Africa, alcohol-related emergency visits can be as high as 57%. The purpose of this prospective study was to establish the prevalence of positive blood alcohol and Blood Alcohol Concentration (BAC) at a tertiary trauma unit in Durban, and to correlate it with injury severity, length of hospital stay and resource utilization. METHOD: A total of 100 patients from King Edward trauma unit were analysed prospectively during the period December 2014 to February 2015...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227050/barriers-to-accessing-atls-provider-course-for-junior-doctors-at-a-major-university-hospital-in-south-africa
#7
J J Odendaal, V Y Kong, T Liu, B Sartorius, G V Oosthuizen, D L Clarke
BACKGROUND: Advanced trauma life support (ATLS) is the international standard of care and forms the basis of trauma training in South Africa. Previous local studies demonstrated a low completion rate among junior doctors (JD). This study was designed to determine the reasons and identify possible barriers of JDs to accessing the ATLS course at a major university hospital. METHOD: This was a prospective study utilising a structured survey that included all JDs who were undertaking their internship training...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/29227049/rib-fracture-fixation-in-a-south-african-public-trauma-service
#8
G V Oosthuizen, J De Wet, J L Bruce, D L Clarke
BACKGROUND: Rib fractures and flail chests have traditionally been treated nonoperatively. Current literature suggests that it is not only safe and feasible but also desirable to perform fixation of severe rib fractures. Our unit in the Pietermaritzburg public sector adopted rib fracture fixation in 2014 and in this audit we assess its feasibility in our setting. METHODS AND RESULTS: We audited our first nine cases of rib fracture fixation performed to date, of which seven were males...
November 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876614/significant-clinical-and-patient-reported-outcomes-at-6-months-following-hernia-repair-with-an-absorbable-fixation-device
#9
H Bougard, C Doerhoff, S Bringman, M Chudy, C Romanowski, P Jones
BACKGROUND: Surgeons utilise various mesh fixation methods during hernia repair which may include tacks/straps and/or sutures. One of these tack/strap choices, is an absorbable fixation device, Securestrap® (ETHICON, Somerville, NJ), consisting of polydioxanone and L (-)-lactide/glycolide copolymer. The 6 month clinical results and patient outcomes with Securestrap® fixation are reported. METHOD: The International Hernia Mesh Registry, prospective multi-centre registry, designed to collect patient reported, longitudinal data on hernia mesh products and fixation methods...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876613/management-and-outcomes-from-appendectomy-an-international-prospective-multicentre-study
#10
J Camilleri-Brennan, T Drake, R Spence, A Bhangu, E Harrison
BACKGROUND: To identify variation in surgical management and outcomes of appendicitis across low, middle and high Human Development Index (HDI) country groups. METHOD: Multi-centre, international prospective cohort study of consecutive patients undergoing emergency appendectomy over a 6-month period. Follow-up lasted 30 days. Primary outcome measure was overall complication rate. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high, 1540 middle and 507 low HDI groups)...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876612/laparoscopic-ventral-hernia-repair-a-single-surgeon-study-using-a-circumferential-transfascial-suture-technique
#11
G Campbell, R P Mills
BACKGROUND: The ideal technique for ventral primary and incisional hernia repair is unclear. There is a paucity of literature from South African authors. In this report, a standardised technique of intraperitoneal mesh placement and fixation is described. METHOD: A retrospective study of 152 patient records. Each patient underwent laparoscopic ventral hernia repair between 2007 and 2016 by a single surgeon. A standardised technique was used in every operation. In each case a circumferential mesh overlap of 5 centimetres from the defect was achieved...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876611/construction-and-validation-of-low-cost-laparoscopic-simulator-using-android-smartphone-and-pop-cast-and-a-laptop
#12
A Vyas, G Goel
Minimal invasive surgery training requires a lot of practice and for this purpose innovative tools are needed to develop methods for practice and training skills outside the operating room. Commercially available devices are readily available but cost effectiveness and availability are major limiting factors in resource limited setting. We present an innovative and cost effective laparoscopic simulator which can be easily manufactured and used for practice of laparoscopic surgery. Using a free android application, such as IP webcam we can relay video to laptop without the use of any cables and uniquely we use the flash of a camera as the light source and a selfie stick for movement of the camera...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876610/the-open-retrorectus-and-transversus-abdominus-release
#13
H Bougard
The open retrorectus approach to the repair of incisional hernias remains the gold standard approach despite the availability of multiple options. The addition of a transverses abdominus release to the procedure increases the number of patients and the complexity of the cases for which this approach is suitable. It facilitates midline closure in almost all cases, avoids significant neuromuscular bundle injury and dissection of poorly vascularized subcutaneous tissue, and allows the placement of a very large but simple mesh in a space outside the peritoneal cavity...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876609/laparoscopic-pancreaticoduodenectomy-at-dr-george-mukhari-academic-hospital-a-case-report
#14
M Govender, C Kalenga, O Mongale, T Mosasi
BACKGROUND: The first total laparoscopic pancreaticoduodenectomy was performed in 1994 by Gagner and Pomp. Their comments coupled with the inherent technical difficulties stifled development of the technique. In the last decade there has been a renewed interest in the technique with high volume centres publishing large series. We present our experience with the first operation completed at Dr George Mukhari Academic Hospital. METHOD: Pre-operative CT confirmed a resectable head of pancreas mass...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876608/laparoscopic-left-lateral-sectionectomy-at-dr-george-mukhari-academic-hospital
#15
M Govender, O Y Matsevych
BACKGROUND: Laparoscopic left lateral sectionectomy has rapidly become a standard of care for patients requiring excision of segments 2 and 3. We present our technique of the resection. METHOD: Videos of patients having had left lateral sectionectomies were reviewed. Patients were placed in supine with reverse Trendelenburg position. Three ports were used: one 12 mm at the umbilicus for the camera, one 12 mm placed 5 cm above and to the right of the umbilicus and one 5 mm port to the left...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876607/laparoscopic-approach-to-combined-bilateral-inguinal-and-ventral-hernias
#16
H Bougard
Herniosis is a well-documented phenomenon amongst patients who develop any hernia over their lifetime. Multiple hernias at different anatomical locations are quite common though they more often occur metachronously. When they present synchronously, there is an additional advantage to tackling these hernias laparoscopically as it affords the advantage of thorough inspection of the entire peritoneal cavity and the ability to address all hernias simultaneously. This video demonstrates one of the modified approached to the groin and midline that facilities a combined procedure without the need for additional port placements...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876606/trauma-laparoscopy-when-to-start-and-when-to-convert
#17
O Matsevych, M Koto, M Balabyeki, C Aldous
BACKGROUND: The use of laparoscopy for stable patients with abdominal trauma is increasing and its accuracy is nearly 100%. However, indications for laparoscopy and for conversion differ among centres. The aim of this study was to investigate indications for trauma laparoscopy and for conversion to laparotomy. METHOD: All trauma patients managed with laparoscopy over a four year period were retrospectively analysed. Indications for laparoscopy, morbidity, and reasons for conversion were investigated and predictors of morbidity and conversion were sought...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876605/trauma-laparoscopy-teaching-an-old-dog-new-tricks
#18
O Matsevych, M Koto, C Aldous
BACKGROUND: Diagnostic laparoscopy is well-accepted in management of penetrating abdominal trauma (PAT) with the rate of missed injuries below 1%. However, there is a reluctance to accept therapeutic laparoscopy in trauma society. The main reason is the lack of laparoscopic skills by trauma surgeons. Moreover, no formal laparoscopy training program for trauma exists. The aim of this study was to discuss the trauma laparoscopy training at our institution. METHOD: All patients managed laparoscopically for PAT from January 2012 to December 2015 were included in the study...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876604/the-use-of-laparoscopy-in-managing-penetrating-thoracoabdominal-injuries-in-africa-83-cases-reviewed
#19
F Mosai
BACKGROUND: The use of laparoscopy in managing haemodynamically stable patients with penetrating thoracoabdominal injuries in developed countries is wildly practiced, but in Africa the use of laparoscopy is still in its infancy stage. We reviewed a single centre experience in using laparoscopy in Africa for management of patients with penetrating diaphragmatic injuries with or without associated intra-abdominal injuries. METHOD: A retrospective analysis of prospectively collected data of patients presenting with penetrating thoracoabdominal injuries was done...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876603/the-role-of-laparoscopy-in-blunt-abdominal-trauma-diagnostic-therapeutic-or-both
#20
F Mosai
BACKGROUND: The use of laparoscopy in blunt abdominal trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. But the feasibility of using laparoscopy for therapeutic intervention in these patients has been debated. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted. METHOD: A retrospective analysis of a prospectively collected data was done...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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