Can open cholecystectomy be taught by cadaveric simulation?

Background: Laparoscopic cholecystectomy (LC) is the current standard of treatment for surgical gallbladder removal as it has an overall improved post-operative recovery compared to Open Cholecystectomy (OC). This has resulted in the loss of exposure to surgical trainees and the associated technical skills and decision-making required to convert to OC. The aim of this study is to provide construct validity to the proposition that cadaveric simulation can be used successfully to teach and learn open cholecystectomy.

The appendix-mucosal immunity and tolerance in the gut: consequences for the syndromes of appendicitis and its epidemiology.

The cause of appendicitis is unknown. A review is presented across diverse sources relating to the biology of the appendix and its perturbations. A mechanistic model of the function of the appendix is presented, and its application to the syndromes and consequences of appendicitis is described.

Achieving High Breast Cancer Survival for Women in Rural and Remote Areas.

Background: Significant improvements in breast cancer survival have been made in the past few decades in many developed countries including Australia with a five-year relative survival of 90%. The aim of the present study is to obtain a brief estimate of the relative importance of demographic factors such as rurality, socio-economic standard and ethnicity versus traditional risk factors for women diagnosed with breast cancer in Far North Queensland, Australia.

Methods: This was a retrospective longitudinal study of all women diagnosed with their first episode of breast cancer in 1999-2013 in Far North Queensland, Australia.

Appendicitis in Far North Queensland: a new take on an old story.

Background: Appendicitis is a leading cause of surgical hospital admission. To date, there have been no published epidemiological studies describing appendicitis in tropical and remote Australia and none specifically documenting appendicitis in Indigenous Australians. This descriptive study used available state data to investigate appendicitis across Far North Queensland (FNQ).

Using a validated tool to assess whole-body cadaveric simulation course on open general and emergency surgery.

Background: The Anatomy of Surgical Exposure (ASE) is a cadaver-based operative surgery simulation course that aims to teach techniques and exposures commonly used in open surgical operations. In this study, we used a validated tool to determine efficacy of assessing skills acquisition in the simulated environment. Our aims were to investigate if the ASE course improves the candidates' surgical performance, and to assess if the validated Objective Structured Assessment of Technical Skill (OSATS) template could be a useful tool for assessing technical skills.

Junior Doctor Experiences and Challenges in Obtaining Surgical Informed Consent: A Qualitative Systematic Review and Meta-Ethnography.

Introduction: Surgical informed consent (SIC) to procedures is necessary to ensure patient autonomy is adequately respected. It is also necessary to protect doctors, and their institutions, from claims of negligence. While SIC is often acquired by senior consultants, it also commonly falls to the junior doctors on a team to ensure SIC is adequately acquired and documented.

The 4-Hour Cairns Sepsis Model: A novel approach to predicting sepsis mortality at intensive care unit admission.

Background: Sepsis commonly causes intensive care unit (ICU) mortality, yet early identification of adults with sepsis at risk of dying in the ICU remains a challenge.

Objective: The aim of the study was to derive a mortality prediction model (MPM) to assist ICU clinicians and researchers as a clinical decision support tool for adults with sepsis within 4 h of ICU admission.

Methods: A cohort study was performed using 500 consecutive admissions between 2014 and 2018 to an Australian tertiary ICU, who were aged ≥18 years and had sepsis.

Appendix redux: a stone unturned.

Recent advances in understanding of the biology of appendicitis are reviewed. Immunological aspects are discussed in the setting of a changing microbiome. Implications for practice are summarized.

Factors influencing breast cancer outcomes in Australia: A systematic review.

Purpose: This systematic review evaluates factors influencing breast cancer outcomes for women treated in Australia, facilitating the exploration of disparities in breast cancer outcomes for certain groups of women in Australia.

Method: A systematic literature search was performed using MEDLINE and Scopus focusing on breast cancer in Australia with outcome measures being breast cancer survival and recurrence with no restrictions on date. Risk of bias was assessed using Cairns Assessment Scale for Observational studies of Risk factors (CASOR).

Selective Cholecystectomy: using an evidence-based prediction model to plan for cholecystectomy.

Background: Symptomatic gall stones are treated safely and efficiently with laparoscopic cholecystectomy. Conversion to open cholecystectomy may be associated with adverse outcomes. Accurate prediction of conversion should decrease the incidence of conversion and improve patient care.

External validation of the Cairns Prediction Model (CPM) to predict conversion from laparoscopic to open cholecystectomy.

Background: Valid and user-friendly prediction models for conversion to open cholecystectomy allow for proper planning prior to surgery. The Cairns Prediction Model (CPM) has been in use clinically in the original study site for the past three years, but has not been tested at other sites.

Methods: A retrospective, single-centred study collected ultrasonic measurements and clinical variables alongside with conversion status from consecutive patients who underwent laparoscopic cholecystectomy from 2013 to 2016 in The Townsville Hospital, North Queensland, Australia.

Symptoms and diagnostic criteria of acquired Megacolon - a systematic literature review.

Background: Acquired Megacolon (AMC) is a condition involving persistent dilatation and lengthening of the colon in the absence of organic disease. Diagnosis depends on subjective radiological, endoscopic or surgical findings in the context of a suggestive clinical presentation. This review sets out to investigate diagnostic criteria of AMC.

The correlation between diverticulosis and redundant colon.

Background: Diverticulosis and redundant colon are colonic conditions for which underlying pathophysiology, management and prevention are poorly understood. Historical papers suggest an inverse relationship between these two conditions. However, no further attempt has been made to validate this relationship.

Complications and Mortality Associated with Temporary Abdominal Closure Techniques: A Systematic Review and Meta-Analysis.

Temporary abdominal closure (TAC) techniques are routinely used in the open abdomen. Ideally, they should prevent evisceration, aid in removal of unwanted fluid from the peritoneal cavity, facilitate in achieving safe definitive fascial closure, as well as prevent the development of intra-abdominal complications. TAC techniques used in the open abdomen were compared with negative pressure wound therapy (NPWT) to identify which was superior.

Treatments and other prognostic factors in the management of the open abdomen: A systematic review.

Background: The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain with it associated with a high incidence of complications and poor outcomes. The objective of this article is to perform a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify prognostic factors in OA patients in regard to definitive fascial closure (DFC), mortality and intra-abdominal complications.

Predicting conversion from laparoscopic to open cholecystectomy presented as a probability nomogram based on preoperative patient risk factors.

Background: We aim to develop a risk stratification tool to preoperatively predict conversion (CONV) from a laparoscopic to open cholecystectomy.

Methods: Multiple risk factors were analyzed with multivariate logistic regression and presented as probability nomograms.

Results: Of 732 patients, 47 (6.

Making a virtue of necessity: managing the open abdomen.

Background: The open abdomen, or laparostomy, is becoming increasingly used in the management of critically ill surgical patients.

Methods: The published work on laparostomy is reviewed, in the light of personal experience, with particular attention to the history and pathophysiology associated with laparostomy.

Results And Conclusion: The combination of an inert plastic sheet in contact with the viscera, and the application of subatmospheric pressure on the wound, is an effective combination to maximize the prospects of delayed primary wound closure while minimizing the chance of fistula and ventral hernia.