Effects of In-House Calls on Medical Students' Perspectives of Surgical Education and Future Career Opportunities.

It has been shown that surgical residents who took few or no in-house calls during medical school felt less prepared for the residency. In this study, our objective was to assess the impact of in-house calls carried out by medical students on their perceptions of medical training, including the influence on specialty choice. The students were asked to complete an anonymized questionnaire at the first and last day of their general surgery clerkship.

Single liver metastasis of a follicular variant of papillary thyroid carcinoma: a rare pattern of organ spread.

Summary: Well-differentiated thyroid cancer (WDTC), including papillary, follicular, and Hurthle-cell types, is characterized by a slow course and usually remain localized to the thyroid. However, a minority of these cases develop distant metastases with the most common sites being lungs, bones, and lymph nodes. Liver metastases of WDTC are rare and are usually found along with other distant metastases sites and in a multiple or diffuse pattern of spread.

Accuracy and inter-operator variability of small bowel length measurement at laparoscopy.

Background: Measurement of bowel length is an essential surgical skill for laparoscopic and open gastrointestinal surgery in order to achieve favorable outcomes and avoid long-term complications. Variations in accuracy between the two surgical approaches may exist. However, only few studies have tried to assess these differences.

Complications after percutaneous ablation of liver tumors: a systematic review.

Background: Although ablation therapy has been accepted as a promising and safe technique for treatment of unrespectable hepatic tumors, investigation of its complications has been limited. A physician who performs ablation treatment of hepatic malignancies should be aware of the broad spectrum of complications. Proper management is possible only if the physician Performing ablation understands the broad spectrum of complications encountered after ablation.

Small for size liver remnant following resection: prevention and management.

In the latest decades an important change was registered in liver surgery, however the management of liver cirrhosis or small size hepatic remnant still remains a challenge. Currently post-hepatectomy liver failure (PLF) is the major cause of death after liver resection often associated with sepsis and ischemia-reperfusion injury (IRI). ''Small-for-size'' syndrome (SFSS) and PFL have similar mechanism presenting reduction of liver mass and portal hyper flow beyond a certain threshold.

"Vanishing liver metastases"-A real challenge for liver surgeons.

Expanded surgical intervention in colorectal liver metastasis (LM) and improved chemotherapy led to increasing problem of disappearing liver metastases (DLM). Treatment of those continues to evolve and poses a real challenge for HPB surgeons. This review discusses a clinical approach to DLM, emphasizing crucial steps in clinical algorithm.

Laparoscopic subtotal gastrectomy for gastric cancer.

Background: The use of laparoscopy in the treatment of gastric malignancy is still controversial. However, several reports suggest that the laparoscopic approach may be safe and applicable. The aim of this study was to review our experience with laparoscopic gastrectomy for gastric malignant tumors amenable to subtotal gastrectomy, and assess the oncologic outcome.

Laparoscopic partial splenectomy using radiofrequency ablation.

Introduction: Epidermoid cysts are believed to be congenital in origin and often present in the pediatric population. Because of the concerns of compromised immunologic function after total splenectomy and increasing demand for minimally invasive approaches, interest has increased in performing the partial splenectomy in this patient population by laparoscopic techniques. Nonetheless, concerns for adequate hemostasis have limited its widespread adoption.

Totally laparoscopic extended left hepatectomy.

This video will discuss the main steps necessary to perform a totally laparoscopic extended left hepatectomy including partial or complete resection of the middle hepatic vein and resection of segment I. Although totally laparoscopic extended liver resections are currently only being performed in several centers with experience in both minimally invasive and hepatobiliary surgery, it will likely become more common, as more surgeons gain expertise in both of these disciplines.

Low incidence of adhesion-related bowel obstruction after laparoscopic colorectal surgery.

Background: Postoperative adhesions are a major cause of morbidity, accounting for approximately 5% of the readmissions of surgical patients. Bowel obstruction is attributed to adhesions in more than half of the cases, many of which are following colon and rectal surgery. Laparoscopic surgery has the potential advantage of reduced adhesion formation owing to attenuated surgical trauma, less tissue handling, and smaller scars.

[Laparoscopic colon and rectal surgery--after ten years and 350 operations].

Background: Within a decade since laparoscopy was used in cholecystectomy it has become the preferred approach in many abdominal procedures. Laparoscopic colon and rectal surgery has not yet been adopted by the majority of surgeons, due to technical complexity and reservation regarding its oncological safety. As data and experience accumulate, this attitude is gradually changing.

Late regeneration of infarcted small bowel mucosa: a case report.

Ischemic injury of the small bowel may recover after revascularization, provided that full-thickness infarction did not occur. Animal studies showed that if the mucosal crypts remain viable, rapid mucosal restitution occurs hours after injury. The treatment of transmucosal infarction that does not extend to full wall thickness, however, was not investigated thoroughly.

[Novel approach to parathyroid adenoma: minimally invasive, focused, scan guided parathyroidectomy--experience from the first 100 cases].

Background: Traditionally, the surgical approach to parathyroid adenoma included formal bilateral neck exploration, inspection and evaluation of all four glands. Recently, following progress in the precision of pre-operative localization by sonography and scintigraphy and the availability of a real time PTH assay, focused, minimally invasive approaches to the removal of a single adenoma were proposed. We review our experience in the first 100 cases.

[The laparoscopic treatment of gallstone ileus].

The laparoscopic approach to abdominal emergencies, including bowel obstruction, has recently become more prevalent. A gallstone, entering the bowel through a cholecysto-enteric fistula, is a rare cause of bowel obstruction. The laparoscopic management of gallstone ileus has been described, but mostly as a laproscopic-assisted procedure, with a limited abdominal incision to treat the obstructed bowel.

Colon and rectal surgery without mechanical bowel preparation: a randomized prospective trial.

Objective: To assess whether elective colon and rectal surgery can be safely performed without preoperative mechanical bowel preparation.

Summary Background Data: Mechanical bowel preparation is routinely done before colon and rectal surgery, aimed at reducing the risk of postoperative infectious complications. However, in cases of penetrating colon trauma, primary colonic anastomosis has proven to be safe even though the bowel is not prepared.