Comparison of Intraoperative Outcomes between Single-incision Robotic Cholecystectomy and Multi-incision Robotic Cholecystectomy.

Background The aim of this study was to evaluate the differences in the key surgical factors for single-incision robotic cholecystectomy (SIRC) and multi-incision robotic cholecystectomy (MIRC). Methods A retrospective data review from August 2013 to April 2018 consisting of 104 SIRC and 105 MIRC cases was done considering factors including patient gender, age, operating time (skin incision to skin closure), robotic console time (docking to undocking), the preoperative diagnosis for surgery, any complications in surgery, length of stay (LOS), and estimated blood loss (EBL). Procedures with conversion away from original robotic cholecystectomy approach were excluded.

Axial-spin technique of endoscopic intracorporeal knot tying: comparison with the conventional technique and objective assessment of knot security, learning curves, and performance efficiency across training levels.

Introduction: A major limitation of conventional laparoscopic surgery is the placement of an intracorporeal (IC) knot, which requires a significant amount of training and practice. An easier technique of IC knot tying using 90-degree grasper is compared with the conventional technique (CLT). The new axial-spin technique (AST) uses the spin of the instrument shaft to tie IC knots.

Differentiation of benign and malignant breast lesions by mechanical imaging.

Mechanical imaging yields tissue elasticity map and provides quantitative characterization of a detected pathology. The changes in the surface stress patterns as a function of applied load provide information about the elastic composition and geometry of the underlying tissue structures. The objective of this study is the clinical evaluation of breast mechanical imager for breast lesion characterization and differentiation between benign and malignant lesions.

Outpatient surgery centers draw cases away from hospitals, impact resident training volume.

Purpose: Across the United States, ambulatory surgery centers (ASCs) are increasing in both number and surgical volume. This trend has been the focus of debate regarding reimbursement and patient safety, as well as surgical productivity and efficiency. However, the impact on surgical resident training caused by this shift toward outpatient surgery in nonhospital settings has not been studied.

The axial-spin technique of intracorporeal knot tying: a novel and simplified approach for junior residents.

Since its introduction, laparoscopic surgery has been limited by various factors including 2-dimensional vision and limited spatial mobility of instruments. A major limitation of conventional laparoscopic surgery is the placement of an intracorporeal knot, which requires a significant amount of training and practice. We describe a novel, easier technique of intracorporeal knot tying using a right-angled 10 mm grasper/mixter.

Training surgeons to do evidence-based surgery: a collaborative approach.

Background: Three of the Accreditation Council for Graduate Medical Education general competencies contain specific wording indicating that trainees must learn how to locate, appraise, and integrate the best information from the literature into their patient care practices. What is less clear is how to best translate evidence-based concepts into the workday of the resident, fellow, or attending surgeon. In this article we describe our use of the assignment-based training program we developed to ensure that our trainees can actually do what is required to practice evidence-based operations.