The joy of surgery: how gender influences surgeons' experiences.

Introduction: Burnout in medicine is an epidemic, and surgeons are not immune. Studies often focus on negative factors leading to burnout, with less emphasis on optimizing joy. The purpose of this study, conducted by the SAGES Reimagining the Practice of Surgery Task Force, was to explore how gender may influence surgeon well-being to better inform organizational change.

The joy of surgery: how surgeons experience joy, time, and support.

Background: Burnout is a crisis in medicine, and especially in surgery it has serious implications not only for physician well-being but also for patient outcomes. This study builds on previous SAGES Reimagining the Practice of Surgery Task Force work to better understand how organizations might intervene to increase the "joy in surgery."

Methods: This was a cross-sectional, descriptive study utilizing a REDCap survey with closed-ended questions for data collection across 5 domains: facilitators of joy, support for best work, time for work tasks, barriers to joy, and what they would do with more time.

Long-Term, Prospective, Multicenter Study of Poly-4-Hydroxybutyrate Mesh (Phasix Mesh) for Hernia Repair in Cohort at Risk for Complication: 60-Month Follow-Up.

Background: Long-term resorbable mesh represents a promising technology for ventral and incisional hernia repair (VIHR). This study evaluates poly-4-hydroxybutyrate mesh (P4HB; Phasix Mesh) among comorbid patients with CDC class I wounds.

Study Design: This prospective, multi-institutional study evaluated P4HB VIHR in comorbid patients with CDC class I wounds.

Prospective, multicenter study of P4HB (Phasix™) mesh for hernia repair in cohort at risk for complications: 3-Year follow-up.

Background: This study represents a prospective, multicenter, open-label study to assess the safety, performance, and outcomes of poly-4-hydroxybutyrate (P4HB, Phasix™) mesh for primary ventral, primary incisional, or multiply-recurrent hernia in subjects at risk for complications. This study reports 3-year clinical outcomes.

Materials And Methods: P4HB mesh was implanted in 121 patients via retrorectus or onlay technique.

The COVID-19 reset: lessons from the pandemic on Burnout and the Practice of Surgery.

Background: Burnout among physicians is an increasing concern, and surgeons are not immune to this threat. The ongoing COVID-19 pandemic has caused dramatic changes to surgeon workflow, often leading to redeployment to other clinical areas, slowdown and shutdown of elective surgery practices, and an uncertain future of surgical practice in the post-pandemic setting. Paradoxically, for many surgeons who had to prepare for but not immediately care for a major surge, the crisis did allow for reflective opportunities and a resetting of priorities that could serve to mitigate chronic patterns contributory to Burnout.

Management of a primary ventral incisional hernia: a survey of the International Hernia Collaboration.

A social media group, the International Hernia Collaboration (IHC), facilitates professional development among surgeons interested in hernia disease. The purpose of this study was to assess practice pattern differences among IHC surgeon members regarding a ventral incisional hernia (VIH) scenario. A single multiple-choice question, posted for 1 month on the IHC, assessed which operation was preferred for a healthy patient with a symptomatic, reducible primary VIH (5 × 6 cm).

A Society of Gastrointestinal and Endoscopic Surgeons (SAGES) statement on closed social media (Facebook®) groups for clinical education and consultation: issues of informed consent, patient privacy, and surgeon protection.

Introduction: Closed social media groups (CSMG), including closed Facebook® groups, are online communities providing physicians with platforms to collaborate privately via text, images, videos, and live streaming in real time and optimize patient care. CSMG platforms represent a novel paradigm in online learning and education, so it is imperative to ensure that the public and patients trust the physicians using these platforms. Informed consent is an essential aspect of establishing this trust.

Prospective evaluation of poly-4-hydroxybutyrate mesh in CDC class I/high-risk ventral and incisional hernia repair: 18-month follow-up.

Background: Long-term resorbable mesh represents a promising technology for complex ventral and incisional hernia repair (VIHR). Preclinical studies indicate that poly-4-hydroxybutyrate (P4HB) resorbable mesh supports strength restoration of the abdominal wall. This study evaluated outcomes of high-risk subjects undergoing VIHR with P4HB mesh.

Erratum to: First human use of hybrid synthetic/biologic mesh in ventral hernia repair: a multicenter trial.

Some values in the pages 1, 3, and 5 of the original article are corrected and also an updated Table 5 is displayed.

Comparative analysis of open and robotic transversus abdominis release for ventral hernia repair.

Background: Transversus abdominis release (TAR) is a safe, effective strategy to repair complex ventral incisional hernia (VIH); however, open TAR (o-TAR) often necessitates prolonged hospitalization. Robot-assisted TAR (r-TAR) may benefit short-term outcomes and shorten convalescence. This study compares 90-day outcomes of o-TAR and r-TAR for VIH repair.

First human use of hybrid synthetic/biologic mesh in ventral hernia repair: a multicenter trial.

Background: Mesh options for reinforcement of ventral/incisional hernia (VIH) repair include synthetic or biologic materials. While each material has known advantages and disadvantages, little is understood about outcomes when these materials are used in combination. This multicenter study reports on the first human use of a novel synthetic/biologic hybrid mesh (Zenapro Hybrid Hernia Repair Device) for VIH repair.

Weight Loss Failure and Reoperation After Laparoscopic Adjustable Gastric Banding and Gastric Bypass: a Case-Matched Cohort Study.

Introduction: Not long ago, laparoscopic adjustable gastric banding (LAGB) was considered a safe and effective treatment of morbid obesity; however, long-term outcomes revealed significant complication and failure rates. We hypothesized that LAGB has higher rates of weight loss failure, reoperation, and overall failure compared to laparoscopic gastric bypass (LRYGB) at long-term follow-up.

Methods: A matched case-control study was performed.

A national survey of educational resources utilized by the Resident and Associate Society of the American College of Surgeons membership.

Background: Contemporary surgical education includes online resources, mobile platform applications, and simulation training. The aim of this study was to characterize educational tools used by surgical residents.

Methods: An anonymous web-based survey was distributed to 9,913 members of the Resident and Associate Society of the American College of Surgeons.

Adrenal myelolipoma: operative indications and outcomes.

Background: Adrenal myelolipoma (AM) is a benign lesion for which adrenalectomy is infrequently indicated. We investigated operative indications and outcomes for AM in a large single-institution series.

Subjects And Methods: A retrospective cohort study of prospectively collected data was conducted.

Risk factors affecting operative approach, conversion, and morbidity for adrenalectomy: a single-institution series of 402 patients.

Background: Risk factors for selecting patients for open adrenalectomy (OA) and for conversion are limited in most series. This study aimed to investigate variables that are important in selecting patients for OA, predict risk of conversion from laparoscopic adrenalectomy (LA), and impact 30-day outcomes of OA and LA.

Methods: A retrospective cohort study of prospectively collected data was conducted.

Evaluation and management of adrenal incidentaloma.

Adrenal incidentaloma is the most common adrenal neoplasm encountered in clinical practice. The timely, accurate, and cost-effective evaluation and management of adrenal lesions found incidentally can be challenging for clinicians. Evaluation begins with biochemical screening and additional imaging.

Giant, metachronous bilateral dorsalis pedis artery true aneurysms.

This report is the first to describe the clinical, radiographic, operative, and pathologic findings associated with large, bilateral dorsalis pedis artery true aneurysms in a single patient. A 61-year-old African American woman complained of difficulty in wearing shoes. She had a moderately firm, nontender, pulsatile mass on the dorsum of her right foot.

Fatigue as impairment or educational necessity? Insights into surgical culture.

Background: The authors examine fatigue culture among surgical residents and faculty members and whether it squares with recent, fatigue-focused Accreditation Council for Graduate Medical Education (ACGME) policies and educational initiatives.

Method: Field observations of an academic general surgery program were supplemented with interviews (52 residents and 58 faculty members) conducted as part of a study of 15 general surgery programs. Field notes and interviews were analyzed for main themes.