Failed recovery after pancreatoduodenectomy: A significant problem even without surgical complications.

Background: The absence of surgical complications has traditionally been used to define successful recovery after pancreas surgery. However, patient-reported outcome measures as metrics of a challenging recovery may be superior to objective morbidity. This study aims to evaluate the use of patient-reported outcomes in assessing recovery after pancreas surgery.

SAGES White Paper on the importance of diversity in surgical leadership: creating the fundamentals of leadership development (FLD) curriculum.

Background: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) has long recognized and championed increasing diversity within the surgical workplace. SAGES initiated the Fundamentals of Leadership Development (FLD) Curriculum to address these needs and to provide surgeon leaders with the necessary tools and skills to promote diversity, equity, and inclusion (DEI) in surgical practice. In 2019, the American College of Surgeons issued a request for anti-racism initiatives which lead to the partnering of the two societies.

Comparison of short- and long-term postoperative occurrences after robotic single-incision cholecystectomy versus multiport laparoscopic cholecystectomy.

Background: Long-term outcomes of SIRC are not well established. Furthermore, SIRC is only now being considered more frequently for patients with independent risk factors for PSH, such as obesity. As such, the paucity of data on longer-term post-surgical outcomes of SIRC is particularly notable as it pertains to obese patients.

The effect of pre-operative diagnosis on patient reported outcomes in patients undergoing colorectal operations: A prospective study.

Introduction: Patient Reported Outcomes (PROs) capture peri-operative fatigue, pain, and quality of life and influence outcomes in gastrointestinal surgery. We compared peri-operative PROs in patients undergoing colorectal operations for neoplastic versus non-neoplastic processes.

Methods: Patients undergoing colectomy were enrolled prospectively.

Prospective longitudinal cohort study of patient recovery after major gastrointestinal surgery: is there a difference between minimally invasive and open approaches?

Background: Surgeons use the absence of post-operative complications to define recovery while patients define recovery as return to normal function. We aimed to better define the recovery process after minimally invasive surgery (MIS) and open gastrointestinal surgery.

Methods: Patients scheduled for open or MIS pancreaticoduodenectomy, esophagectomy, colectomy, and proctectomy were prospectively enrolled.

Faculty Diversity at Academic Surgical Meetings-Opportunity for Action?

Background: The American Surgical Association delineated deficiencies of diversity, equity, and inclusion within academic surgery. Opportunities to increase diversity are membership in surgical societies and leadership development. We hypothesized that surgical society meetings represent additional opportunities, using gender diversity as an example.

Laparoscopic celiac plexus ganglioneuroma resection: A video case report.

Background: Ganglioneuromas are mature, benign neurogenic tumors that arise from neural crest-derived cells. Given the rarity of these tumors and their often close proximity to major vessels, there is a paucity of reports in the literature of minimally invasive resections of ganglioneuromas near the celiac plexus. We report a case of laparoscopic resection of a retroperitoneal ganglioneuroma adhering to the portal vein and celiac axis.

Surgical team workload comparison for 4-port and single-port laparoscopic cholecystectomy procedures.

Advanced minimally invasive procedures may cause postural constraints and increased workload and stress for providers. This study compared workload and stress across surgical team roles for 48 laparoscopic cholecystectomies (4-port vs single-port) using a task load index (NASA-TLX), a procedural difficulty question, and salivary stress hormones. Statistical analyses were performed based on the presence intra-cluster correlation within team roles, at α=0.

Is functional gallbladder disease truly increasing? Results from the Rochester Epidemiology Project.

Introduction: Reports from US administrative databases showed an increase in cholecystectomy rate for functional gallbladder disorder (FGBD), a disease is not well recognized elsewhere. We aimed to identify the incidence and cholecystectomy rate for FGBD in an epidemiologically well-defined and prospectively studied population and compare results to published data.

Methods: After IRB approval, we extracted data from the NIH funded Rochester Epidemiology Project.

How much pain relief do patients expect after cholecystectomy?

Background: Cholecystectomy is a common operation, increasingly performed, in the USA, for "functional gall bladder disorder" (FGBD). Outcomes of these surgeries are uncertain. In planning a study of FGBD, we needed to define the best outcome measures.

Validation of a Novel Inverted Peg Transfer Task: Advancing Beyond the Regular Peg Transfer Task for Surgical Simulation-Based Assessment.

Objective: To evaluate the validity of a novel inverted peg transfer (iPT) task for assessing laparoscopic skills of novices and experts and compare iPT to the regular PT (rPT) task to ensure surgical trainee acquisition of an adequate advanced laparoscopic skills level for safe laparoscopic practice in the operating room.

Design: Prospective crossover study.

Setting: Multidisciplinary simulation center and motion analysis laboratory, Mayo Clinic.

Gender disparities in the utilization of laparoscopic groin hernia repair.

Background: Clinical treatment guidelines have suggested that laparoscopic hernia repair should be the preferred approach in both men and women with bilateral or recurrent elective groin hernias. Anecdotal evidence suggests, however, that women are less likely to undergo a laparoscopic repair than men, and therefore, we aimed to delineate if these disparities persisted after controlling for patient factors and comorbidities.

Materials And Methods: The American College of Surgeons National Surgical Quality Improvement Project data were abstracted for all elective groin hernia repairs between 2005 and 2014.

The impact of intraoperative microbreaks with exercises on surgeons: A multi-center cohort study.

Recent literature has demonstrated ergonomic risk to surgeons in the operating room. One method used in other industries to mitigate these ergonomic risks is the incorporation of microbreaks. Thus, intraoperative microbreaks with exercises in a non-crossover design were studied.

Intraoperative "Micro Breaks" With Targeted Stretching Enhance Surgeon Physical Function and Mental Focus: A Multicenter Cohort Study.

Objective: The aim of this study was to investigate the effect of intraoperative targeted stretching micro breaks (TSMBs) on the experienced pain and fatigue, physical functions, and mental focus of surgeons.

Background: Surgeons are routinely subject to mental and physical stresses through the course of their work in the operating room. One of the factors most contributory to the shortening of a surgeon's career is work-related pain and its effects on patient safety and personal relationships.

The use of patient factors to improve the prediction of operative duration using laparoscopic cholecystectomy.

Background: Reliable prediction of operative duration is essential for improving patient and care team satisfaction, optimizing resource utilization and reducing cost. Current operative scheduling systems are unreliable and contribute to costly over- and underestimation of operative time. We hypothesized that the inclusion of patient-specific factors would improve the accuracy in predicting operative duration.

Effects of carbon dioxide insufflation during direct cholangioscopy on biliary pressures and vital parameters: a pilot study in porcine models.

Background And Aims: Direct per-oral cholangioscopy allows endoscopic visualization of the biliary tract. Insufflation with carbon dioxide (CO) is an alternative to saline solution irrigation during direct cholangioscopy. There are no data on maximal CO insufflation in direct cholangioscopy without causing biliary barotrauma or fatal gas embolism.

Patient-Reported Outcomes after Laparoscopic Ventral Hernia Repair.

Approximately 350,000 ventral hernia repairs are performed in the United States each year. Patients expect fast recovery after laparoscopic ventral hernia repair (LVHR) and undisturbed postoperative quality of life (QOL). We examined the utility of a brief, validated 10-point Linear Analog Self-Assessment coupled with the Visual Analog Scale pain scale to discern risk factors for decreased postoperative QOL.

Single-incision laparoscopic resection of small bowel tumours: Making it easier for patient and surgeon.

Background: Patients with small bowel tumours frequently require surgical intervention. Minimally invasive techniques require advanced skills and may not be offered to many patients. We present a laparoscopic single-incision technique that is minimally invasive without requiring intracorporeal anastomosis.

Impact of patient factors on operative duration during laparoscopic cholecystectomy: evaluation from the National Surgical Quality Improvement Program database.

Background: Patient factors impact laparoscopic cholecystectomy (LC) difficulty, specifically operative duration. This study quantifies the impact of patient factors on LC duration.

Methods: The national surgery database (American College of Surgeons National Surgical Quality Improvement Program) was reviewed for all elective LC for biliary colic from 2005 to 2013.

Functional gallbladder disease: Operative trends and short-term outcomes.

Background: Due to increasing rates of functional gallbladder disease (FGBD), we used national data to compare rates, patient characteristics, and outcomes of cholecystectomy for FGBD with the more defined diagnosis of biliary colic.

Methods: The American College of Surgeons National Surgical Quality Improvement Program was reviewed for elective cholecystectomies from 2005-2013. The proportion of cholecystectomies performed for FGBD was assessed over time using a 2-sided Cochran-Armitage test for trend.