Comparison of index and reoperative bowel resections in Crohn's disease.

Background: There is a scarcity of literature describing outcomes of reoperative Crohn's disease. An in-depth knowledge of these outcomes is critical for managing patient expectations and optimal perioperative planning. We sought to examine outcomes in patients undergoing reoperative surgeries for Crohn's disease compared to index operations.

Laparoscopic vs robotic inguinal hernia repair: a comparison of learning curves and skill transference in general surgery residents.

Background: There is no consensus on whether laparoscopic experience should be a prerequisite for robotic training. Further, there is limited information on skill transference between laparoscopic and robotic techniques. This study focused on the general surgery residents' learning curve and skill transference within the two minimally invasive platforms.

Real-time near infrared artificial intelligence using scalable non-expert crowdsourcing in colorectal surgery.

Surgical artificial intelligence (AI) has the potential to improve patient safety and clinical outcomes. To date, training such AI models to identify tissue anatomy requires annotations by expensive and rate-limiting surgical domain experts. Herein, we demonstrate and validate a methodology to obtain high quality surgical tissue annotations through crowdsourcing of non-experts, and real-time deployment of multimodal surgical anatomy AI model in colorectal surgery.

Inflammatory bowel disease-associated colorectal cancer negatively affects surgery outcomes and health care costs.

Background: Inflammatory bowel disease may affect the pathogenesis and clinicopathologic course of colorectal cancer. We sought to characterize the impact of inflammatory bowel disease on outcomes after colectomy and/or proctectomy for a malignant indication.

Methods: Patients diagnosed with colorectal cancer as well as a pre-existing comorbid diagnosis of Crohn's disease or ulcerative colitis between 2018 and 2021 were identified from Medicare claims data.

Clinical Utility of Laser Speckle Contrast Imaging and Real-Time Quantification of Bowel Perfusion in Minimally Invasive Left-Sided Colorectal Resections.

Background: Left-sided colorectal surgery demonstrates high anastomotic leak rates, with tissue ischemia thought to influence outcomes. Indocyanine green is commonly used for perfusion assessment, but evidence remains mixed for whether it reduces colorectal anastomotic leaks. Laser speckle contrast imaging provides dye-free perfusion assessment in real-time through perfusion heat maps and quantification.

What would you do (WWYD)? Thinking outside the virtual lecture box during COVID-19 and beyond.

Background: The COVID-19 pandemic disrupted many aspects of personal and professional life for surgeons, with resulting suspension of many in-person educational opportunities in favor of virtual education programs. Adapting to these new challenges, we developed, implemented, and evaluated a novel approach to Department of Surgery Grand Rounds to meet the educational needs of residents.

Methods: At the outset of COVID-19-related restrictions, educational leadership performed a needs assessment of resident education, leading to a quick pivot to video-based programming.

Cumulative Sum Chart as Complement to Objective Assessment of Graduating Surgical Resident Competency: An Exploratory Study.

Background: Rater-based assessment and objective assessment play an important role in evaluating residents' clinical competencies. We hypothesize that a cumulative sum (CUSUM) chart of operative time is a complement to the assessment of chief general surgery residents' competencies with ACGME Milestones, aiding residency programs' determination of graduating residents' practice readiness.

Study Design: We extracted ACGME Milestone evaluations of performance of operations and procedures (POP) and 3 objective metrics (operative time, case type, and case complexity) from 3 procedures (cholecystectomy, colectomy, and inguinal hernia) performed by 3 cohorts of residents (N = 15) during their PGY4-5.

The SAGES MASTERS program presents: the top 10 seminal articles for laparoscopic left and sigmoid colectomy pathway for uncomplicated disease.

Background: As one of the 8 Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Masters Program clinical pathways, the Colorectal Pathway aims to deliver educational content for the general surgeon organized along 3 levels of performance (competency, proficiency and mastery) each represented by an anchoring procedure. In this article, the SAGES Colorectal Task Force presents focused summaries of the top 10 seminal articles selected for laparoscopic left/sigmoid colectomy for uncomplicated disease.

Methods: Using a systematic literature search of Web of Science, the most cited articles on laparoscopic left and sigmoid colectomy were identified, reviewed, and ranked by members of the SAGES Colorectal Task Force.

Cost analysis of training residents in robotic-assisted surgery.

Introduction: Use of robotic-assisted surgery is increasing, and resident involvement may lead to higher costs. We investigated whether senior resident involvement in noncomplex robotic cholecystectomy (RC) and inguinal hernia (RIH) would take more time and cost more when compared to non-robotic cholecystectomy (NRC) and inguinal hernia repair (NRIH).

Methods: We extracted surgery duration and total cost of NRC, NRIH, RC, and RIH from 7/2016 to 6/2020 with senior resident (PGY4-5) involvement.

Operative Coaching for General Surgery Residents: Review of Implementation Requirements.

Operative coaching offers a unique opportunity to strengthen surgery residents' skill sets and practice readiness. However, institutional organizational capacity may influence the ability to successfully implement and sustain a coaching program. This review concentrates on the implementation requirements as they relate to institutional organizational capacity to help evaluate and determine if adopting such a coaching model is feasible.

A Multicenter Analysis of the Early Impact of COVID-19 on Junior Resident Operative Case Volume.

Introduction: Institutions have reported decreases in operative volume due to COVID-19. Junior residents have fewer opportunities for operative experience and COVID-19 further jeopardizes their operative exposure. This study quantifies the impact of the COVID-19 pandemic on resident operative exposure using resident case logs focusing on junior residents and categorizes the response of surgical residency programs to the COVID-19 pandemic.

All Politics Are Local: A Single Institution Investigation of the Educational Impact of Residents and Fellows Working Together.

Background: Most general surgery residents pursue fellowship; there is limited understanding of the impact residents and fellows have on each other's education. The goal of this exploratory survey was to identify these impacts.

Materials And Methods: Surgical residents and fellows at a single academic institution were surveyed regarding areas (OR assignments, the educational focus of the team, roles and responsibilities on the team, interpersonal communication, call, "other") hypothesized to be impacted by other learners.

Education Morbidity and Mortality: Reviving Intraoperative Teaching and Learning.

Background: Using the platform of morbidity and mortality conference, we developed and executed a combined faculty-resident intervention called "Education M&M" to discuss challenges faced by both parties in the operating room (OR), identify realistic solutions, and implement action plans. This study aimed to investigate the impact of this intervention on resident OR training.

Materials And Methods: Two resident case presentations were followed by audience discussion and recommendations regarding actionable solutions aimed at improving resident OR training from an expert faculty panel.

Efficiency of Increasing Prospective Resident Entrustment in the Operating Room.

Background: Prospective resident entrustment (i.e., trust an attending surgeon intends to give to a resident in the near future) in the operating room (OR) closely associates with granted future autonomy.

Postoperative Ileus and Postoperative Gastrointestinal Tract Dysfunction: Pathogenic Mechanisms and Novel Treatment Strategies Beyond Colorectal Enhanced Recovery After Surgery Protocols.

Postoperative ileus (POI) and postoperative gastrointestinal tract dysfunction (POGD) are well-known complications affecting patients undergoing intestinal surgery. GI symptoms include nausea, vomiting, pain, abdominal distention, bloating, and constipation. These iatrogenic disorders are associated with extended hospitalizations, increased morbidity, and health care costs into the billions and current therapeutic strategies are limited.

Surgical Residents' Perceptions of the Impact of Productivity-Based Faculty Compensation at an Academic Medical Center.

Background: Academic medical centers have increasingly adopted productivity-based compensation models for faculty. The potential exists for conflict between financial incentives and the quality of surgical resident education. This study aims to examine surgical residents' perceptions regarding the impact of productivity-based compensation on education.

Resident Self-Entrustment and Expectations of Autonomy: OB > GYN?

Introduction: Entrustment is a key component connecting to resident preparedness for surgical practice in the operating room (OR). Residents' self-entrustment of their surgical competencies closely associates with their OR training experience and granted autonomy. Some recent studies have investigated how attending surgeons entrusted residents in the OR.

Phase I Trial of Trametinib with Neoadjuvant Chemoradiation in Patients with Locally Advanced Rectal Cancer.

Purpose: The RAS/RAF/MEK/ERK signaling pathway is critical to the development of colorectal cancers, and , , and mutations foster resistance to radiation. We performed a phase I trial to determine the safety of trametinib, a potent MEK1/2 inhibitor, with 5-fluorouracil (5-FU) chemoradiation therapy (CRT) in patients with locally advanced rectal cancer (LARC).

Patients And Methods: Patients with stage II/III rectal cancer were enrolled on a phase I study with 3+3 study design, with an expansion cohort of 9 patients at the MTD.