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https://www.readbyqxmd.com/read/27922990/robotically-assisted-thoracic-surgery-proposed-guidelines-for-privileging-and-credentialing
#1
Faiz Y Bhora, Adnan M Al-Ayoubi, Sadiq S Rehmani, Craig M Forleiter, Wissam N Raad, Scott G Belsley
OBJECTIVE: Increased use of robotically assisted thoracic surgery (RATS) necessitates effective credentialing guidelines to ensure safe outcomes. We provide a stepwise algorithm for granting privileges and credentials in RATS. This algorithm reflects graduated responsibility and complexity of the surgical procedures performed. Furthermore, it takes into account volume, outcomes, surgeon's competency, and appropriateness of robot usage. METHODS: We performed a literature review for available strategies to grant privileges and credentials for implementing robotic surgery...
December 5, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27922866/quality-and-safety-in-health-care-part-xix-variants-of-the-eras-program
#2
Jay A Harolds
The integrated recovery pathway is a variant of the enhanced recovery pathway after surgery program, which saw a further decrease in complications and mean length of stay after a change in culture was instituted with more accountability of the staff to following the pathway. This was accomplished using a team-based comprehensive unit-based safety program. It has also been found that another variant of the enhanced recovery pathway after surgery program had a further improvement of patient outcomes after instituting a "preventive surgical site infection bundle...
December 3, 2016: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/27922837/safety-of-overlapping-surgery-at-a-high-volume-referral-center
#3
Joseph A Hyder, Kristine T Hanson, Curtis B Storlie, Amy Glasgow, Nageswar R Madde, Michael J Brown, Daryl J Kor, Robert R Cima, Elizabeth B Habermann
OBJECTIVE: To compare safety profiles of overlapping and nonoverlapping surgical procedures at a large tertiary-referral center where overlapping surgery is performed. BACKGROUND: Surgical procedures are frequently performed as overlapping, wherein one surgeon is responsible for 2 procedures occurring at the same time, but critical portions are not coincident. The safety of this practice has not been characterized. METHODS: Primary analyses included elective, adult, inpatient surgical procedures from January 2013 to September 2015 available through University HealthSystem Consortium...
December 5, 2016: Annals of Surgery
https://www.readbyqxmd.com/read/27922581/pseudomeningocele-aspiration-and-blood-patch-effectively-treats-positional-headache-associated-with-post-operative-lumbosacral-pseudomeningocele
#4
Stephen Sandwell, Kevin Walter, Per-Lennart Westesson
STUDY DESIGN: Retrospective chart review with limited prospective follow-up survey. OBJECTIVE: To evaluate the efficacy and safety of blood patch injection for the treatment of positional headaches caused by postoperative lumbosacral pseudomeningoceles. SUMMARY OF BACKGROUND DATA: Pseudomeningocele is one of the most common complications after posterior lumbosacral spinal surgery. Common treatments include bedrest, abdominal binder use, subarachnoid lumbar drainage, and surgical re-exploration for durotomy closure...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27922572/comparative-study-between-pedicle-subtraction-osteotomy-pso-and-closing-opening-wedge-osteotomy-fish-mouth-pso-for-sagittal-plane-deformity-correction
#5
Jong-Hwa Park, Seung-Jae Hyun, Ki-Jeong Kim, Tae-Ahn Jahng
STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate the safety and efficacy of closing-opening wedge osteotomy (COWO: fish-mouth pedicle subtraction osteotomy [PSO]), for sagittal plane deformity correction and to compare the radiographical outcomes for patients undergoing conventional- and fish-mouth PSO. SUMMARY OF BACKGROUND DATA: The COWO has been developed to achieve a large magnitude of correction at a single level for patients with severe fixed sagittal imbalance...
December 2, 2016: Spine
https://www.readbyqxmd.com/read/27921198/-metabolic-surgery-or-conservative-measures-as-therapy-of-obese-type%C3%A2-2%C3%A2-diabetics
#6
REVIEW
Udo Jahn, Thomas Schubert, Sibylle Schlepp, Heinz Jürgen Deuber
After bariatric surgery there are some favourable effects on comorbidities of obesity as glucose and lipid metabolism besides weight loss. Therefore surgical measures targeting at improvement of such metabolic disorders especially diabetes type 2 has been called "metabolic surgery". The complexity of its underlying metabolic mechanisms is not yet clear, but restriction of energy and weight loss (maintenance) seem to be the cornerstones.Risks of these procedures which are drawn of the established methods of bariatric surgery are reported to be relatively low in qualified centers...
December 5, 2016: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27919836/concomitant-hiatal-hernia-repair-with-laparoscopic-sleeve-gastrectomy-is-safe-analysis-of-the-acs-nsqip-database
#7
Hanaa N Dakour Aridi, Hani Tamim, Aurelie Mailhac, Bassem Y Safadi
BACKGROUND: Gastroesophageal acid reflux disease (GERD) is prevalent after laparoscopic sleeve gastrectomy (LSG), a common bariatric surgical procedure worldwide. Some studies have suggested that concomitant hiatal hernia repair (HHR) during LSG reduces the risk of GERD, but this has not been substantiated. Little is known about the safety of adding an HHR in this setting. The present study aims to compare 30-day morbidity and mortality and length of hospital stay between patients undergoing LSG alone and those undergoing LSG with HHR...
October 5, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27919009/successful-percutaneous-ct-guided-microwave-ablation-of-adrenal-gland-for-ectopic-cushing-syndrome
#8
Rebecca Zener, Andrew Zaleski, Stan H Van Uum, Daryl K Gray, Amol Mujoomdar
Adrenocorticotropic hormone production by pancreatic neuroendocrine tumor (PNET) is rare and results in hyperstimulation of the adrenal gland to produce ectopic Cushing syndrome. Our case showcases the safety and effectiveness of percutaneous CT-guided microwave ablation of the adrenal gland in a 49-year-old female with PNET and hepatic metastases who presented with ectopic Cushing syndrome despite surgical resection of the primary pancreatic tumor and left adrenal gland. Prior to ablation, the right adrenal gland measured 4...
November 29, 2016: Clinical Imaging
https://www.readbyqxmd.com/read/27918347/the-stereo-electroencephalography-the-epileptogenic-zone
#9
Jorge A Gonzalez-Martinez
The stereo-electroencephalography (SEEG) methodology and technique was developed almost 60 years ago in Europe and it has proven its efficacy and safety over the last 55 years. The main advantage of the SEEG method is the possibility to study the epileptogenic neuronal network in its dynamic and tri-dimensional aspect, with an optimal time and space correlation with the clinical semiology. In this manuscript, the technical and methodological aspects of the SEEG will be discussed focusing on the planning of SEEG implantations, technical nuances, conceptualization of the epileptogenic zone, and the different methods of SEEG-guided surgical resections and ablations...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27918344/implantation-of-stereoelectroencephalography-electrodes-a-systematic-review
#10
Francesco Cardinale, Giuseppe Casaceli, Fabio Raneri, Jonathan Miller, Giorgio Lo Russo
BACKGROUND: Stereoelectroencephalography (SEEG) was developed by Talairach and Bancaud in Paris in the late 1950s. Subsequently, the Talairach methodology was adopted at a number of additional centers in Europe and Canada. Technical aspects remained essentially unchanged for the following 30 years. Only in the last two decades, because of advancements in image-guided surgery systems, robotics, and computer-aided planning, use of SEEG has become more widespread, and reports describing these new developments have been published...
December 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27918335/consensus-bundle-on-prevention-of-surgical-site-infections-after-major-gynecologic-surgery
#11
Joseph E Pellegrini, Paloma Toledo, David E Soper, William C Bradford, Deborah A Cruz, Barbara S Levy, Lauren A Lemieux
Surgical site infections are the most common complication of surgery in the United States. Of surgeries in women of reproductive age, hysterectomy is one of the most frequently performed, second only to cesarean birth. Therefore, prevention of surgical site infections in women undergoing gynecologic surgery is an ideal topic for a patient safety bundle. The primary purpose of this safety bundle is to provide recommendations that can be implemented into any surgical environment in an effort to reduce the incidence of surgical site infection...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27918213/percutaneous-therapies-for-tricuspid-regurgitation
#12
Erin A Fender, Rick A Nishimura, David R Holmes
Chronic tricuspid valve regurgitation is usually associated with left-sided heart disease or pulmonary hypertension. Although severe tricuspid valve regurgitation carries a poor prognosis, isolated surgery is rarely performed due to high in-hospital mortality and an unclear impact on long term survival. The lack of adequate surgical treatment has resulted in a large population of patients with an unmet clinical need. Areas Covered: Transcatheter therapies have revolutionized the management of high risk patients with left-sided valvular disease, and have sparked interest in translating minimally invasive therapies to the tricuspid valve...
December 5, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27917666/safety-of-out-of-hours-operating-in-trauma-and-orthopaedics-at-a-district-general-hospital
#13
M A Gulamhussein, S Chaudhry, S Noor, T Chaudhry, A Guha, R Knebel
INTRODUCTION According to the National Confidential Enquiry into Perioperative Deaths (NCEPOD), out-of-hours operating in trauma and orthopaedics should be reserved for life or limb threatening cases only. The aim of our study was to determine the nature of non-emergency work carried out in our trust at night in 2015. The overall efficacy and clinical safety of the services provided was evaluated. METHODS Surgical activity undertaken after 9pm was reviewed along with patient ASA (American Society of Anesthesiologists) grade, grade of operating surgeon and any complications that occurred following the procedure...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27917532/do-women-have-a-choice-care-providers-and-decision-makers-perspectives-on-barriers-to-access-of-health-services-for-birth-after-a-previous-cesarean
#14
Sarah Munro, Jude Kornelsen, Kitty Corbett, Elizabeth Wilcox, Nick Bansback, Patricia Janssen
BACKGROUND: Repeat cesarean delivery is the single largest contributor to the escalating cesarean rate worldwide. Approximately 80 percent of women with a past cesarean are candidates for vaginal birth after a cesarean (VBAC), but in Canada less than one-third plan VBAC. Emerging evidence suggests that these trends may be due in part to nonclinical factors, including care provider practice patterns and delays in access to surgical and anesthesia services. This study sought to explore maternity care providers' and decision makers' attitudes toward and experiences with providing and planning services for women with a previous cesarean...
December 5, 2016: Birth
https://www.readbyqxmd.com/read/27916638/therapeutical-options-in-the-management-of-carotid-dissection
#15
Ombretta Martinelli, Salvatore Venosi, Jamila BenHamida, Alban Malay, Cristina Belli, Francesco Giosue' Irace, Roberto Gattuso, Giacomo Frati, Bruno Gossetti, Luigi Irace
OBJECTIVE: The best management of carotid artery dissection (CAD) is still controversial ranging from antiplatelet medication to open surgery or endovascular treatment. In this retrospective study we assessed the safety and efficacy of endovascular stent angioplasty for the treatment of CAD. METHODS: From February 2006 to February 2016, 44 patients (28 females and 16 males, age range 25-65 years, mean 42) with CAD were included in this study. The internal carotid artery (ICA) dissection was spontaneous in origin in 32 patients and post-traumatic in the remaining 12 (1 case it was bilateral)...
December 1, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27916365/efficacy-and-safety-of-innoseal-for-air-leak-after-pulmonary-resection-a-case-control-study
#16
Francesco Petrella, Alessandro Borri, Daniela Brambilla, Giorgio Calanca, Nicola Vezzani, Antonio Colantoni, Adolfo Gasparetto, Lorenzo Spaggiari
BACKGROUND: Prolonged air leak is one of the most common complications after lung surgery and the cause of prolonged hospital stay frequently associated with major postoperative morbidity and thus responsible for even higher hospital costs. This case-control study was designed to test the sealing efficacy and safety of Enable-Innoseal TP4 in patients undergoing pulmonary resection for lung cancer. METHODS: This was a case-control trial enrolling patients with primary or single site metastatic lung cancer scheduled for elective anatomic or nonanatomic pulmonary resection presenting intraoperative grade 1 or 2 air leak at water submersion test; the study group population was then matched 1:1 according to surgical procedure, male/female ratio, preoperative FEV1, and age...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916205/efficacy-and-safety-of-transdermal-testosterone-in-postmenopausal-women-with-hypoactive-sexual-desire-disorder-a-systematic-review-and-meta-analysis
#17
Chiara Achilli, Jyotsna Pundir, Parimalam Ramanathan, Luca Sabatini, Haitham Hamoda, Nick Panay
OBJECTIVE: To systematically review and summarize the existing evidence related to the efficacy and safety of transdermal T in postmenopausal women for the treatment of hypoactive sexual desire disorder (HSDD). DESIGN: Systematic reviews and meta-analysis. SETTING: Not applicable. PATIENT(S): Seven randomized controlled trials enrolled 3,035 participants; 1,350 women were randomized to treatment with T patch, and 1,379 women were randomized to placebo...
December 1, 2016: Fertility and Sterility
https://www.readbyqxmd.com/read/27915486/evaluation-of-the-axonics-modulation-technologies-sacral-neuromodulation-system-for-the-treatment-of-urinary-and-fecal-dysfunction
#18
Joshua A Cohn, Casey G Kowalik, Melissa R Kaufman, W Stuart Reynolds, Douglas F Milam, Roger R Dmochowski
Sacral neuromodulation (SNM) remains one of the few effective treatments for refractory bladder and bowel dysfunction. However, SNM is associated with frequent need for surgical intervention, in many cases because of a failed battery. A rechargeable SNM system, with a manufacturer-reported battery life of 15 years or more, has entered post-market clinical testing in Europe but has not yet been approved for clinical testing in the United States. Areas covered: We review existing neuromodulation technologies for the treatment of lower urinary tract and bowel dysfunction and explore the limitations of available technology...
December 4, 2016: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27915065/assessment-of-white-matter-transgression-during-neuroendoscopic-procedures-using-dti-fiber-tracking
#19
Sergio García, Jordina Rincon-Torroella, Arnau Benet, Laura Oleaga, José Juan González Sánchez
BACKGROUND: Presurgical planning allows anticipating intraoperative difficulties, increasing efficiency, and reducing risks. Neuroendoscopy is a minimally invasive technique whose related complications have been focused on cortical function and surface vessels injury. However, white matter disruption has been insufficiently acknowledged. OBJECTIVE: To present a new surgical planning method based on diffusion tensor image that allows quantifying subcortical transgression and optimizing neuroendoscopic trajectories...
November 30, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27914839/late-in-the-bag-intraocular-lens-dislocation-a-randomized-clinical-trial-comparing-lens-repositioning-and-lens-exchange
#20
Olav Kristianslund, Marianne Råen, Atle E Østern, Liv Drolsum
PURPOSE: To compare the efficacy and safety of 2 operation methods for late in-the-bag intraocular lens (IOL) dislocation. DESIGN: Prospective, randomized, parallel-group surgical trial. PARTICIPANTS: Patients referred to Oslo University Hospital (tertiary referral center). METHODS: We randomly assigned 104 patients (104 eyes) either to IOL repositioning by scleral suturing (n = 54) or to IOL exchange with retropupillary fixation of an iris-claw IOL (n = 50)...
November 30, 2016: Ophthalmology
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