Robotic Resection of Left Atrial Myxoma With Cryoablation of Tumor Stalk.

The purpose of this report is to demonstrate robotic cryoablation of an atrial myxoma stalk as a method to prevent recurrence and preserve atrial tissue. A 38-year-old female patient was taken to the operating room, and an atrial myxoma abutting the left inferior pulmonary vein was resected robotically. This was followed by cryoablation of the tumor stalk instead of a full-thickness resection to prevent an extensive reconstruction.

Rural General Surgery Experience as a Valuable Adjunct to an Academic Based General Surgery Residency.

Objective: Few general surgery residencies offer rural rotations. We aim to evaluate the contribution of our institution's rural rotation to meeting the Accreditation Council for Graduate Medical Education (ACGME) minimum case requirements for graduation, and residents' perceptions of the educational value of this rotation.

Design: ACGME case log data were obtained from categorical general surgery residents who had completed at least 1 month-long rural surgery rotation and 1 month-long general surgery rotation at our academic medical center within the same clinical year.

Prospective Assessment of Postoperative Nausea Early After Bariatric Surgery.

Background: The most common reason for readmission after bariatric surgery is postoperative nausea and vomiting (PONV). The aim of this study was to compare the incidence and severity of PONV between patients undergoing laparoscopic sleeve gastrectomy (SG) and gastric bypass (GB).

Methods: This was a prospective observational cohort study that evaluated all patients who underwent non-revisional isolated SG or GB at a tertiary care center.

Perioperative safety of laparoscopic versus robotic gastric bypass: a propensity matched analysis of early experience.

Background: The role of robotic assistance for gastric bypass remains controversial. Using a large nationwide cohort, we compared early outcomes after robotic Roux-en-Y gastric bypass (Robot-RYGB) with the laparoscopic technique (LRYGB).

Objective: This study aimed to use a bariatric-specific, large, nationwide cohort with several years of data to compare the early postoperative outcomes of the Robot-RYGB and LRYGB.

Trainee-associated outcomes in laparoscopic colectomy for cancer: propensity score analysis accounting for operative time, procedure complexity and patient comorbidity.

Background: Surgical trainee association with operative outcomes is controversial. Studies are conflicting, possibly due to insufficient control of confounding variables such as operative time, case complexity, and heterogeneous patient populations. As operative complications worsen long-term outcomes in oncologic patients, understanding effect of trainee involvement during laparoscopic colectomy for cancer is of utmost importance.

REBOA for the IVC? Resuscitative balloon occlusion of the inferior vena cava (REBOVC) to abate massive hemorrhage in retrohepatic vena cava injuries.

Background: The use of resuscitative endovascular balloon occlusion as a maneuver for occlusion of the aorta is well described. This technique has life-saving potential in other cases of traumatic hemorrhage. Retrohepatic inferior vena cava (IVC) injuries have a high rate of mortality, in part, due to the difficulty in achieving total vascular isolation.

The effect of close postoperative follow-up on co-morbidity improvement after bariatric surgery.

Background: Patients undergoing gastric bypass (RYGB) surgery require follow-up for efficacy assessment, early detection of postoperative complications, and also for management of co-morbid conditions. Recent literature shows support for improved long-term weight loss with close patient follow-up. However, attrition rates after RYGB have been reported as high as 50%.

Post-operative morbidity, but not mortality, is worsened by operative delay in septic diverticulitis.

Purpose: Optimal timing of surgery for acute diverticulitis remains unclear. A non-operative approach followed by elective surgery 6-week post-resolution is favored. However, a subset of patients fail on the non-operative management during index admission.

Effect of Surgeon Volume on Sleeve Gastrectomy Outcomes.

Background: Prior studies have shown a relationship between surgeon volume and patient outcomes in Roux-en-Y gastric bypass (RYGB) patients. Laparoscopic sleeve gastrectomy (SG) is now the most common bariatric procedure, but there is a little data on surgeon volume and outcomes after SG. We examined the relationship between annual surgeon bariatric volume and 30-day complication rate after SG.

A History of Bariatric Surgery: The Maturation of a Medical Discipline.

This article examines the progression of bariatric surgery since its creation more than 60 years ago with a focus on the effect of surgery on weight loss, comorbidity reduction, and safety. The success has been remarkable. It is possible to cure severe obesity, type 2 diabetes, and hyperlipidemia in addition to the many other manifestations of the metabolic syndrome with remarkable safety.

Surgeon case volume and readmissions after laparoscopic Roux-en-Y gastric bypass: more is less.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a commonly performed bariatric procedure. Readmissions are used as a quality indicator with a nationwide emphasis on reduction. In LRYGB surgery, surgeon volume studies have focused on correlation with technical outcomes, offering limited data on readmissions.

Comparative effectiveness of Roux-en-Y gastric bypass and sleeve gastrectomy in super obese patients.

Background: The disproportionate increase in the super obese (SO) is a hidden component of the current obesity pandemic. Data on the safety and efficacy of bariatric procedures in this specific patient population are limited. Our aim is to assess the comparative effectiveness of the two most common bariatric procedures in the SO.

Causes of readmission after laparoscopic and open ventral hernia repair: Identifying failed discharges and opportunities for action.

Background: Thirty-day hospital readmissions are used as an indicator of quality for health care systems. The timing of readmissions after ventral hernia repair (VHR) is poorly defined, and its relationship to laparoscopic or open technique is unclear. The aim of this study was to assess differences between early and late readmissions after VHR.

Postoperative Follow-up After Bariatric Surgery: Effect on Weight Loss.

While adherence to long-term follow-up after bariatric surgery is a mandate for center of excellence certification, the effect of attrition on weight loss is not well understood. The aim of this study was to assess the effect of postoperative follow-up on 12-month weight loss using the Bariatric Outcomes Longitudinal Database (BOLD) dataset. Patients with complete follow-up (3, 6, and 12 months) were compared to patients who had one or more prior missed visits.