The Ability of Healthcare Professionals to Predict Patient Outcomes Following Bariatric Surgery.

Introduction: Patients with obesity seeking bariatric surgery undergo an extensive evaluation by a multidisciplinary team of healthcare professionals' (HCPs) to assess patient compliance among other factors and determine their eligibility for surgery. However, the HCPs' assessments are not devoid of bias that may affect eligibility and preoperative decisions. This study aimed to investigate team members' ability to predict patient outcomes following bariatric surgery.

Does the length of bypassed bowel during distal gastric bypass affect weight loss?

Introduction: Weight recurrence (WR) affects > 20% of patients following Roux-en-Y gastric bypass (RYGB). Shortening of the common channel (CC) after RYGB (distal bypass) has been proposed for additional weight loss in patients with WR, but results vary, and concerns for vitamin deficiencies/malnutrition exist. Our aim was to determine whether the percentage of bowel bypassed after distal bypass is associated with the amount of postoperative weight loss.

Evaluation of a passive arm-support exoskeleton for surgical team members: Results from live surgeries.

Background: Musculoskeletal symptoms and injuries adversely impact the health of surgical team members and their performance in the operating room (OR). Though ergonomic risks in surgery are well-recognized, mitigating these risks is especially difficult. In this study, we aimed to assess the impacts of an exoskeleton when used by OR team members during live surgeries.

SAGES guideline for the diagnosis and treatment of appendicitis.

Background: Appendicitis is an extremely common disease with a variety of medical and surgical treatment approaches. A multidisciplinary expert panel was convened to develop evidence-based recommendations to support clinicians and patients in decisions regarding the diagnosis and treatment of appendicitis.

Methods: A systematic review was conducted from 2010 to 2022 to answer 8 key questions relating to the diagnosis of appendicitis, operative or nonoperative management, and specific technical and post-operative issues for appendectomy.

SAGES guidelines for the use of laparoscopy during pregnancy.

Background: When pregnant patients present with nonobstetric pathology, the physicians caring for them may be uncertain about the optimal management strategy. The aim of this guideline is to develop evidence-based recommendations for pregnant patients presenting with common surgical pathologies including appendicitis, biliary disease, and inflammatory bowel disease (IBD).

Methods: The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Guidelines Committee convened a working group to address these issues.

Evaluation of operating room inefficiencies and their impact on operating room duration using a surgical app.

Background: Efficient utilization of the operating room (OR) is essential. Inefficiencies are thought to cause preventable delays. Our goal was to identify OR incidents causing delays and estimate their impact on the duration of various general surgery procedures.

Patients' perspectives on weight recurrence after bariatric surgery: a single-center survey.

Background: Weight recurrence (WR) affects nearly 20% of patients after bariatric surgery and may decrease its benefits, affecting patients' quality of life negatively. Patient perspectives on WR are not well known.

Objectives: Assess patient needs, goals, and preferences regarding WR treatment.

Does the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program bariatric risk/benefit calculator hold its weight? An assessment of its accuracy.

Background: Bariatric clinical calculators have already been implemented in clinical practice to provide objective predictions of complications and outcomes. The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Surgical Risk/Benefit Calculator is the most comprehensive risk calculator in bariatric surgery.

Objectives: Evaluate the accuracy of the calculator predictions regarding the 30-day complication risk, 1-year weight loss outcomes, and comorbidity resolution.

SAGES peritoneal dialysis access guideline update 2023.

Background: Minimally invasive surgery has been used for both de novo insertion and salvage of peritoneal dialysis (PD) catheters. Advanced laparoscopic, basic laparoscopic, open, and image-guided techniques have evolved as the most popular techniques. The aim of this guideline was to develop evidence-based guidelines that support surgeons, patients, and other physicians in decisions on minimally invasive peritoneal dialysis access and the salvage of malfunctioning catheters in both adults and children.

Diagnosis and treatment of appendicitis: systematic review and meta-analysis.

Background: The optimal diagnosis and treatment of appendicitis remains controversial. This systematic review details the evidence and current best practices for the evaluation and management of uncomplicated and complicated appendicitis in adults and children.

Methods: Eight questions regarding the diagnosis and management of appendicitis were formulated.

Relationship between stress and resident non-technical skills during interdisciplinary trauma simulations.

Background: Non-technical skills, such as communication and situation awareness, are vital for patient care and effective surgical team performance. Previous research has found that residents' perceived stress is associated with poorer non-technical skills; however, few studies have investigated the relationship between objectively assessed stress and non-technical skills. Accordingly, the purpose of this study was to assess the relationship between objectively assessed stress and non-technical skills.

Venous thromboembolism (VTE) prophylaxis after bariatric surgery: a national survey of MBSAQIP director practices.

Background: Venous thromboembolism (VTE) is the most common cause of death following metabolic/bariatric surgery (MBS), with most events occurring after discharge. The available evidence on ideal prophylaxis type, dosage, and duration after discharge is limited.

Objectives: Assess metabolic/bariatric surgeon VTE prophylaxis practices and define existing variability.

Patient perspectives on the usefulness of the MBSAQIP Bariatric Surgical Risk/Benefit Calculator: a randomized controlled trial.

Background: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Bariatric Surgical Risk/Benefit Calculator uses procedure-specific prediction models to generate individualized surgical risk/outcome estimates. This tool helps guide informed consent and operative selection. We hypothesized that calculator use would influence patient procedure choice.

Multi-society consensus conference and guideline on the treatment of gastroesophageal reflux disease (GERD).

Background: Gastroesophageal reflux disease (GERD) is one of the most common diseases in North America and globally. The aim of this guideline is to provide evidence-based recommendations regarding the most utilized and available endoscopic and surgical treatments for GERD.

Methods: Systematic literature reviews were conducted for 4 key questions regarding the surgical and endoscopic treatments for GERD in adults: preoperative evaluation, endoscopic vs surgical or medical treatment, complete vs partial fundoplication, and treatment for obesity (body mass index [BMI] ≥ 35 kg/m) and concomitant GERD.

Proton pump inhibitor prophylaxis after Roux-en-Y gastric bypass: A national survey of surgeon practices.

Background: Proton pump inhibitors (PPIs) are frequently used after Roux-en-Y gastric bypass (RYGB) to prevent marginal ulceration. The optimal duration of PPI treatment after surgery to minimize ulcer development is unclear.

Objectives: Assess bariatric surgeon practice variability regarding postoperative PPI prophylaxis.

Distal gastric bypass revision for weight recurrence or nonresponse to primary procedure: initial experience and outcomes in an academic practice.

Background: Considerable weight recurrence (WR) after Roux-en-Y gastric bypass (RYGB) may occur in nearly 20% of patients. While several nonoperative, endoscopic, and surgical interventions exist for this population, the optimal approach is unknown. This study reports our initial experience with distal bypass revision (DGB) and provides a comparison with patients after primary RYGB.

Early postoperative weight loss predicts nadir weight and weight regain after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass.

Background: Weight regain (WR) post bariatric surgery affects almost 20% of patients. It has been theorized that a complex interplay between physiologic adaptations and epigenetic mechanisms promotes WR in obesity, however, reliable predictors have not been identified. Our study examines the relationship between early postoperative weight loss (WL), nadir weight (NW), and WR following laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (LSG).

Objective Nontechnical Skills Measurement Using Sensor-based Behavior Metrics in Surgical Teams.

Objective: The purpose of this study was to identify objective measures that predict surgeon nontechnical skills (NTS) during surgery.

Background: NTS are cognitive and social skills that impact operative performance and patient outcomes. Current methods for NTS assessment in surgery rely on observation-based tools to rate intraoperative behavior.

A comparison of laparoscopic and robotic ergonomic risk.

Introduction: Work related injuries in minimally invasive surgery (MIS) are common because of the strains placed on the surgeon's or assistant's body. The objective of this study was to compare specific ergonomic risks among surgeons and surgical trainees performing robotic and laparoscopic procedures.

Materials And Methods: Ergonomic data and discomfort questionnaires were recorded from surgeons and trainees (fellows/residents) for both robotic and laparoscopic procedures.

Resilience matters: Student perceptions of the impact of COVID-19 on medical education.

Introduction: We assessed students' perception of the impact of the pandemic on their well-being, education, academic achievement, and whether grit and resilience alter students' ability to mitigate the stress associated with disruptions in education. We hypothesized that students would report a negative impact, and those with higher grit and resilience scores would be less impacted.

Methods: A multidisciplinary team of educators created and distributed a survey to medical students.

Assessment of Chief Resident Practice Readiness in a Porcine Lab: A 4-Year Experience.

Objective: General surgery training prepares residents for the autonomous practice of surgery; however, assessment for readiness for independent practice presents several challenges. The simulation lab offers a safe and standardized environment for assessing the technical skills of a resident in the absence of numerous confounders of the real operating room. We describe our experience with evaluation and remediation of chief resident assessments in a porcine simulation lab.

Postoperative 4-Year Outcomes in Septuagenarians Following Bariatric Surgery.

Background: Bariatric surgery is the most effective treatment for obesity; however, its utilization in older patients remains low. There is a dearth of literature on long-term effectiveness and safety of bariatric surgery in septuagenarian patients. The aim of this study was to compare the short- and long-term outcomes of bariatric surgery in this population.

Thyroid cancer surgery during the coronavirus disease 2019 pandemic: perioperative management and oncological and anatomical considerations.

The coronavirus disease 2019 (COVID-19) pandemic has changed many aspects of our everyday lives and medical practice, including oncology treatment; thyroid cancer surgery is not an exception. The reported number of fine-needle aspirations performed during the first semester of 2020 was significantly reduced. Poorly differentiated, medullary and anaplastic thyroid tumors are considered important indications for immediate surgical intervention.