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Experience of surgeons in Operation theatres

David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Bridget Gray, Andrew Briggs, Ranjit Lall, Tim Js Chesser, Ian Pallister, Sarah E Lamb, Keith Willett
BACKGROUND: Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES: We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN: A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study...
October 2016: Health Technology Assessment: HTA
Yang Yu, Guantao Lou, Chen Shen, Sheng Guan, Wei Wang, Bo Yang
: TUERP, which is based on TURP, technically has been proven to be safe and effective with reduced complication rates. Due to the lack of systematic pre-clinical training, the surgery is learnt only inside the operative theatre in the majority of the Chinese medical centers. It is also known to have a steep learning curve, and very few articles have addressed the technical aspects of TUERP. MATERIAL AND METHODS: The videos of 91 cases of bipolar transurethral enucleation and resection of the prostate, which were performed by one urological surgeon in our department from August 2013 to January 2016, were retrospectively analyzed...
September 23, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
Praveer K Banerjee, Abhineet Jain, Bikram Behera
BACKGROUND AND AIMS: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. METHODS: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone...
August 2016: Indian Journal of Anaesthesia
H M Joshi, E Alabraba, A Tufo, A Zone, P Ghaneh, S W Fenwick, G J Poston, H Z Malik
INTRODUCTION: Indicative numbers for completion of training (CCT) in the UK requires 35 upper Gastrointestinal/Hepatobiliary resections and 110 (50 non HPB trainees) cholecystectomies. We aim to identify whether the training experience in our centre meets the CCT requirements for hepatobiliary surgery and compare training opportunities to those in international fellowships. METHODS: We retrospectively reviewed our hospital's operating theatre database for all patients undergoing a liver or gallbladder resection between January 2008 and July 2015 using corresponding procedural codes and consultant name...
October 2016: European Journal of Surgical Oncology
Shinichiro Sakata, Philip M Grove, Andrew Hill, Marcus O Watson, Andrew R L Stevenson
PURPOSE: Surgeons conventionally assume the optimal viewing position during 3D laparoscopic surgery and may not be aware of the potential hazards to team members positioned across different suboptimal viewing positions. The first aim of this study was to map the viewing positions within a standard operating theatre where individuals may experience visual ghosting (i.e. double vision images) from crosstalk. The second aim was to characterize the standard viewing positions adopted by instrument nurses and surgical assistants during laparoscopic pelvic surgery and report the associated levels of visual ghosting and discomfort...
August 19, 2016: Langenbeck's Archives of Surgery
Sofia Erestam, Eva Angenete, Kristoffer Derwinger
BACKGROUND: A pause routine may reduce stress and errors during surgery. The aim of this study was to explore how the team, divided into the different professional groups, perceived the implementation of a pause routine and its possible impact on safety. METHODS: A pause routine was introduced at a University hospital operating theatre in Sweden in 2013. Questionnaires were distributed about 1 year later to all members of the operating theatre team. The questions included different perspectives of possible effects of the pause routine...
July 14, 2016: World Journal of Surgery
Tiffany Wong, Chang Qi Hester Lau, Eng Loy Tan, Devendra Kanagalingam
INTRODUCTION: This study aimed to determine the decision-to-delivery intervals (DDIs), total duration of surgery and factors influencing these for caesarean sections (CSs). METHODS: A retrospective study was conducted of all CSs performed from August 2013 to June 2014 at a single tertiary general hospital. Data collected included maternal demographics, indications for CS, category of urgency, DDI, total duration of surgery, grade of first surgeon and number of previous CSs...
June 1, 2016: Singapore Medical Journal
Candice D Silverman, Michael A Ghusn
BACKGROUND: The use of robotic platforms in bariatric surgery has recently gained relevance. With an increased use of this technology come concerns regarding learning curve effects during the initial implementation phase. The sleeve gastrectomy though may represent an ideal training procedure for introducing the robot into bariatric surgical practice. The present review of the first 10 consecutive robotic sleeve gastrectomy procedures performed in an Australian bariatric programme by a single surgeon describes the evolution of the technique, learning curve and initial patient outcomes...
April 15, 2016: ANZ Journal of Surgery
Sven Young, Leonard Banza, Nyengo Mkandawire
BACKGROUND: Attempts to address the huge, and unmet, need for surgical services in Africa by training surgical specialists in well established training programmes in high-income countries have resulted in brain drain, as most trainees do not return home on completion of training for various reasons. Local postgraduate training is key to retaining specialists in their home countries. International institutional collaborations have enabled Kamuzu Central Hospital (KCH) in Lilongwe, Malawi, to start training their own surgical specialists from 2009...
2016: SpringerPlus
Edmund Fitzgerald O'Connor, Warren Matthew Rozen, Muhammad Chowdhry, Bassam Band, Venkat V Ramakrishnan, Matthew Griffiths
BACKGROUND: The approach and operative techniques associated with breast reconstruction have steadily been refined since its inception, with abdominal perforator-based flaps becoming the gold standard reconstructive option for women undergoing breast cancer surgery. The current study comprises a cohort of 632 patients, in whom specific operative times are recorded by a blinded observer, and aims to address the potential benefits seen with the use of computer tomography (CT) scanning preoperatively on operative outcomes, complications and surgical times...
April 2016: Gland Surgery
Giovanni Bellanova, Francesco Buccelletti, Riccardo Berletti, Marco Cavana, Giorgio Folgheraiter, Francesca Groppo, Chiara Marchetti, Amelia Marzano, Alessandro Massè, Antonio Musetti, Tina Pelanda, Nicola Ricci, Gregorio Tugnoli, Damiano Papadia, Claudio Ramponi
AIM: Aim of this study is to analyze how the starting of Course of Trauma in our hospital improved survival and organization in management of polytraumatized patients. MATERIAL OF STUDY: We analysed all major trauma patients (Injury Severity Score (Injury Severity Score (ISS)> 15) treated at Emergency Department of the Santa Chiara Hospital between January 2011 and December 2014. The training courses (TC) were named "management of polytrauma" (MP) and "clinical cases discussion" (CCD), and started in November 2013...
2016: Annali Italiani di Chirurgia
K W M See, K H Chui, W H Chan, K C Wong, Y C Chan
BACKGROUND: Simulation training in endovascular surgery provides opportunities for trainees to practice and learn from non-patient based experience. Several types of endovascular simulators are available commercially. Previous studies on endovascular simulation training can be categorized into trials in which only a simulator was used when measuring performance metrics or "trials within simulation"; patient specific procedure rehearsals; and randomized, controlled trials (RCTs) or translational studies...
March 2016: European Journal of Vascular and Endovascular Surgery
W Rodgers, T Lloyd, K Mizen, L Fourie, H Nishikawa, H Rakhorst, A Schmidt, D Kuoraite, N Bulstrode, D Dunaway
The surgical treatment of defects caused by noma is challenging for the surgeon and the patient. Local flaps are preferred, but sometimes, because of the nature of the disease, there is not enough local tissue available. We describe our experience of free tissue transfer in Ethiopia. Between 2008 and 2014, 34 microsurgical procedures were done over 11 missions with the charity Facing Africa, predominantly for the treatment of defects caused by noma (n=32). The mean duration of operation was 442 minutes (range 200 - 720)...
January 2016: British Journal of Oral & Maxillofacial Surgery
Jeff Bezemer, Terhi Korkiakangas, Sharon-Marie Weldon, Gunther Kress, Roger Kneebone
AIM: To explore the unsettling effects of increased mobility of nurses, surgeons and other healthcare professionals on communication and learning in the operating theatre. BACKGROUND: Increasingly, healthcare professionals step in and out of newly formed transient teams and work with colleagues they have not met before, unsettling previously relatively stable team work based on shared, local knowledge accumulated over significant periods of close collaboration. DESIGN: An ethnographic case study was conducted of the operating theatre department of a major teaching hospital in London...
February 2016: Journal of Advanced Nursing
Anais Rosich-Medina, Serafeim Bouloumpasis, Michele Di Candia, Charles M Malata
INTRODUCTION: The total 'rib'-preservation method of dissecting out the internal mammary vessels (IMV) during microvascular breast reconstruction aims to reduce free flap morbidity at the recipient site. We review our five-year experience with this technique. PATIENTS & METHODS: An analysis of a prospectively collected free flap data cohort was undertaken to determine the indications, operative details and reconstructive outcomes in all breast reconstruction patients undergoing IMV exposure using the total 'rib'-preservation method by a single surgeon...
September 2015: Annals of Medicine and Surgery
E-Ern Ian Ng, James French, Jeremy Hsu, Elisabeth E Elder
BACKGROUND: Conservative treatment of inferior breast cancers has been a challenge for breast surgeons due to the high incidence of poor cosmetic outcomes. In 2008, Renouvel et al. described an oncoplastic 'Crescent' technique utilizing an advancement flap to fill the defect after cancer excision in the lower pole of the breast. A follow-up study demonstrated no local recurrence at 45 months and excellent or good cosmetic outcomes in over 70% of patients. This study aims to assess the outcomes of applying this 'Crescent' technique in a breast surgical unit...
January 2016: ANZ Journal of Surgery
Ee Shern Liang, Geoffrey Tipper, Lyn Hunt, Peter Yee Chiung Gan
INTRODUCTION: The resurgence of decompressive craniectomy has led to recent published reviews of the safety of cranioplasties. To date there is a wide range of reported mortality and morbidity. This observational study reports the outcomes of the cranioplasty operations from a single centre and evaluates the factors involved in their management. METHODS: A retrospective search of all theatre logs was performed for the years 2006-2013 inclusive. 88 operations were documented as 'Cranioplasty'...
2016: British Journal of Neurosurgery
K-W Baek, W Deibel, D Marinov, M Griessen, A Bruno, H-F Zeilhofer, Ph Cattin, Ph Juergens
Laser was being used in medicine soon after its invention. However, it has been possible to excise hard tissue with lasers only recently, and the Er:YAG laser is now established in the treatment of damaged teeth. Recently experimental studies have investigated its use in bone surgery, where its major advantages are freedom of cutting geometry and precision. However, these advantages become apparent only when the system is used with robotic guidance. The main challenge is ergonomic integration of the laser and the robot, otherwise the surgeon's space in the operating theatre is obstructed during the procedure...
December 2015: British Journal of Oral & Maxillofacial Surgery
Jochen Bergs, Frank Lambrechts, Pascale Simons, Annemie Vlayen, Wim Marneffe, Johan Hellings, Irina Cleemput, Dominique Vandijck
OBJECTIVE: The objective of this review is to obtain a better understanding of the user-related barriers against, and facilitators for, the implementation of surgical safety checklists. METHODS: We searched MEDLINE for articles describing stakeholders' perspectives regarding, and experiences with, the implementation of surgical safety checklists. The quality of the papers was assessed by means of the Qualitative Assessment and Review Instrument. Thematic synthesis was used to integrate the emergent descriptive themes into overall analytical themes...
December 2015: BMJ Quality & Safety
Basil Enicker, Sonwabile Gonya, Timothy C Hardcastle
BACKGROUND: Spinal stab wounds presenting with retained knife blades (RKB) are uncommon, often resulting in spinal cord injury (SCI) with catastrophic neurological consequences. The purpose of this study is to report a single unit's experience in management of this pattern of injury at this regional referral centre. METHODS: Retrospective review of medical records identified 51 consecutive patients with spinal stabs presenting with a RKB at the Neurosurgery Department at Inkosi Albert Luthuli Central Hospital between January 2003 and February 2015...
September 2015: Injury
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