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.

Chronic immunosuppressant use in colorectal cancer patients worsens postoperative morbidity and mortality through septic complications in a propensity-matched analysis.

Aim: Chronic immunosuppressant use increases the risk of septic complications after colectomy; however, adverse effects on other organ systems remain poorly understood. The aim of this study was to evaluate the multisystem organ effect(s) of chronic immunosuppressant(s) in colorectal cancer patients.

Methods: This was a retrospective study.

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.

Proposal for a unified classification system and nomenclature of lagoviruses.

Lagoviruses belong to the Caliciviridae family. They were first recognized as highly pathogenic viruses of the European rabbit (Oryctolagus cuniculus) and European brown hare (Lepus europaeus) that emerged in the 1970-1980s, namely, rabbit haemorrhagic disease virus (RHDV) and European brown hare syndrome virus (EBHSV), according to the host species from which they had been first detected. However, the diversity of lagoviruses has recently expanded to include new related viruses with varying pathogenicity, geographic distribution and host ranges.

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.

Prevention of eating disorders and obesity via the internet.

Internet technology has been expanding rapidly and has had a dramatic impact on how people communicate, learn and share information. This article presents applications of internet technology to the psychological domain, particularly in the prevention and treatment of eating disorders and obesity. Information regarding advantages and disadvantages of computerized interventions are discussed and several examples of randomized controlled trials with this technology are presented.

Improving compliance in on-line, structured self-help programs: evaluation of an eating disorder prevention program.

Compliance rates from four iterations of Student Bodies, an 8-10 week computer assisted health education (CAHE) program for the prevention of eating disorders in college-aged women, were measured. Each iteration was modified with the hope of increasing participant compliance. Participants were 116 undergraduate women from two large West Coast universities who were randomly assigned to either the CAHE program or a wait-list group.

Application of an algorithm-driven protocol to simultaneously provide universal and targeted prevention programs.

Objective: Our objective was to develop a model to simultaneously prevent eating disorders and weight gain among female high school students.

Method: Of 188 female 10th graders enrolled in health classes, 174 elected to participate in the current study. They were assessed on-line and decided to participate in one of four interventions appropriate to their risk.

A comparison of the binge eating scale, questionnaire for eating and weight patterns-revised, and eating disorder examination questionnaire with instructions with the eating disorder examination in the assessment of binge eating disorder and its symptoms.

Objective: The current study assesses concordance between self-administered measures and a diagnostic standard for assessment of binge frequency and diagnosis of binge eating disorder (BED) in a sample of binge eaters.

Method: The Questionnaire for Eating and Weight Patterns-Revised (QEWP-R), Binge Eating Scale (BES), two items from the Eating Disorder Examination Questionnaire with Instructions (EDE-Q-I), and the Eating Disorder Examination (EDE) were administered. Participants were 157 adults volunteering for a clinical study, of whom 129 (79%) were diagnosed with BED using the EDE as the diagnostic standard.

Comparison of self-report to interview assessment of bulimic behaviors among preadolescent and adolescent girls and boys.

Objective: To compare self-report to interview assessment of bulimic behaviors among adolescents.

Method: A sample of children in an ongoing study were recruited to complete in-depth telephone interviews in 1998 on bulimic behaviors (i.e.

Are adolescents harmed when asked risky weight control behavior and attitude questions? Implications for consent procedures.

Objectives: This study explores whether asking minors about risky weight control behaviors and attitudes increases the frequency of those behaviors and attitudes.

Methods: Participants were 115 sixth-grade girls who responded to questions on risky weight control behaviors and attitudes at baseline and at 12-month follow-up. An additional 107 girls, who had not been part of the baseline, provided data only at follow-up.

Reducing risk factors for eating disorders: targeting at-risk women with a computerized psychoeducational program.

Objective: This controlled study evaluated whether an 8-week program offered over the Internet would significantly decrease body image dissatisfaction, disordered eating patterns, and preoccupation with shape/weight among women at high risk for developing an eating disorder.

Method: Fifty-six college women were recruited on the basis of elevated scores (> or =110) on the Body Shape Questionnaire (BSQ). Psychological functioning, as measured by the Eating Disorder Inventory Drive for Thinness (EDI-DT) subscale, Eating Disorder Examination-Questionnaire (EDE-Q), and the BSQ, was assessed at baseline, posttreatment, and at 10-week follow-up.

Reducing risk factors for eating disorders: comparison of an Internet- and a classroom-delivered psychoeducational program.

This controlled trial compared Internet- (Student Bodies [SB]) and classroom-delivered (Body Traps [BT]) psychoeducational interventions for the reduction of body dissatisfaction and disordered eating behaviors/attitudes with a control condition. Participants were 76 women at a private university who were randomly assigned to SB, BT, or a wait-list control (WLC) condition. Measures of body image and eating attitudes and behaviors were measured at baseline, posttreatment, and 4-month follow-up.