Transfer of training in robotic-assisted microvascular surgery.

Background: Transfer of training refers to the ability to transfer acquired skills from one discipline to another. This study aims to determine whether experience in traditional freehand microsurgery facilitates mastery of robotic microsurgery.

Methods: Microsurgical anastomoses of coronary arteries harvested from explanted pig models were used to demonstrate whether prior experience with microsurgery is required in learning robot-assisted microsuturing.

Feasibility of robotic-assisted microvascular anastomoses in plastic surgery.

In this pilot trial in piglets, the authors demonstrated the feasibility of applying robot technology to vascular microsurgery. This preliminary work suggests certain advantages of the robot, which should encourage more rigorous study for its full exploitation.

Pediatric burns with snap-cap fireworks.

Snap-caps are marketed as a relatively safe pyrotechnic (explosive) device for children 8 years and older. Individually, the snap-caps pose very little threat because the amount of explosive compounds contained in each is limited to 1 mg. However, the accidental explosion of numerous snap-caps may cause significant burns.

The effects of restricted work hours on clinical training.

Resident education has changed dramatically over the past 10 years. With the implementation of restricted work hours on clinical training, questions have arisen whether these restricted hours will affect clinical competency. This manuscript attempts to answer this question through a survey performed to assess the perception of residents about duty-hour restrictions and the potential effect on residents' clinical exposure.

Inclusion of sevoflurane in cardioplegia reduces neutrophil activity during cardiopulmonary bypass.

Objective: The purpose of this study was to examine the effects of sevoflurane cardioplegia on neutrophil response and complement activation after cardiopulmonary bypass (CPB).

Design: A prospective, randomized clinical investigation.

Setting: University-affiliated hospital; single institutional.

The telecommunication revolution in the medical field: present applications and future perspective.

In the present review, we analyze the achievements of telecommunication innovations in the medical field focusing on patient care and medical-education aspects. In this regard, the telecommunication revolution has offered medical professionals the possibility to transmit information of any sort zeroing transmission time latency and annihilating spatial distances. Although telemedicine is still in its infancy, multiple applications of this science have already been successfully tested.

The world wide web and robotic heart surgery.

Purpose: The primary goal of this study was to (1) determine patients' access to and use of the Internet for healthrelated information before and after endoscopic atraumatic coronary artery bypass (Endo-ACAB) surgery, (2) investigate patients' methods of searching for such information, and (3) suggest future improvements for Internet-based patient education. The secondary goal of this study was to determine (1) patients' health-related quality of life and (2) degree of satisfaction following the Endo-ACAB procedure.

Methods: A follow-up study was conducted of 50 consecutive patients who had undergone Endo-ACAB procedures at the Center for Less Invasive Cardiac Surgery and Robotic Heart Surgery in Buffalo, New York.

Does repair of mitral regurgitation eliminate the need for left ventricular volume reduction?

Background: Effects of partial left ventriculectomy (PLV) remain ill-defined because mitral regurgitation (MR) repair by isolated annuloplasty alone has been reported to improve patients with dilated left ventricle and severe MR.

Methods: Among patients undergoing PLV, 120 had paired pre- and postoperative (<1 week) Doppler echocardiograms. Effects of preoperative MR were studied by comparing 45 patients with no preoperative MR (MR-) and 75 patients with significant MR (MR+; MR = 1.

Factors affecting ventricular function and survival after partial left ventriculectomy.

Background: Partial left ventriculectomy (PLV) helps some patients but is deleterious in others. Selection of patients who will benefit from PLV, and exclusion of those who will not is necessary for safe and effective application of the procedure.

Methods: Sixty-nine consecutive patients who underwent PLV were monitored with pressure-volume relationship analyses, Doppler echocardiography, and histopathologic studies of excised myocardium.

A porcine beating heart model for robotic coronary artery surgery.

Background: The application of robotically assisted coronary artery surgery continues to be investigated clinically. Consequently, there is a need for a simple method to train surgeons in performing these operations. The aim of the present study was to assess a model using an excised porcine heart for the training of surgeons in creating a robotically assisted arterial anastomosis.

REVIEW: Fast-Tracking Cardiac Surgery.

A "fast track" approach to cardiac surgery can be defined as a perioperative process involving rapid progress from preoperative preparation through surgery and discharge from the hospital. Although highly individualized among the various heart surgery centers, the fast-track process is a team activity. It requires a team of health care providers to interact with the patient at various phases, from admission to discharge.

Are you ready to become a robo-surgeon?

Robotic and minimally invasive surgery represents the future of modern surgical care. However, its role during the training of surgical residents has yet to be investigated. A previous study conducted by our group surveyed program directors at accredited general surgery training programs in the United States to determine the prevalence and application of robotics in their residency programs.

Heparin dose, transfusion rates, and intraoperative graft patency in minimally invasive direct coronary artery bypass.

Background: Many investigators have demonstrated the short-term and midterm efficacy of minimally invasive direct coronary artery bypass (MIDCAB). However, the influence of heparin dosing during MIDCAB on postoperative and immediate graft patency is less well defined. This report outlines our experience with MIDCAB employing a variety of heparinization protocols.

A pediatric surgery study: parent usage of the Internet for medical information.

Purpose: The goal of this study was to (1) determine parents access to and use of the Internet for information relating to their child's health; (2) investigate parents methods of searching for such information; and (3) evaluate the information found in relation to its readability, accuracy, and influence.

Methods: A study was conducted of 150 parents of outpatients in the Pediatric Surgery Clinic of a local Children's Hospital. Parents completed study surveys over a 6-week time frame.

Minimally invasive mitral valve surgery: from Port Access to fully robotic-assisted surgery.

Currently, there is a growing interest in minimally invasive cardiac surgery, and despite early criticisms, it has become the preferred method of mitral valve repair and replacement in many institutions worldwide with excellent results. The interest in performing cardiac valve operations through minimal incisions was stimulated by Port Access technology and has evolved to include robotically assisted video-enhanced valve surgery. Robotic assistance has led to shorter operating times and represents an ideal tool to prepare for fully robotic-assisted cardiac procedures.

The hybrid approach to coronary artery revascularization: minimally invasive direct coronary artery bypass with percutaneous coronary intervention.

In the past decade, new developments in cardiology and cardiac surgery have begun to offer patients a variety of new, less invasive options for the treatment of coronary artery disease. One such option is the hybrid approach to coronary artery revascularization. This combines minimally invasive direct coronary artery bypass surgery (MIDCAB) of the left anterior descending artery (LAD) with percutaneous coronary intervention (PCI) of the remaining diseased coronary arteries.

Hybrid robotic coronary artery surgery and angioplasty in multivessel coronary artery disease.

Background: Complete surgical revascularization that includes left internal thoracic artery grafting to the left anterior descending coronary artery remains the gold standard of treatment for coronary artery disease. Not all patients are good candidates for sternotomy. Therefore, we sought to identify a strategy that would combine the long-term advantages of internal thoracic artery grafting to lessen surgical trauma while still allowing complete revascularization.