Integration of a formalized handoff system into the surgical curriculum: resident perspectives and early results.

Hypothesis: The Situation, Background, Assessment, and Recommendation model (SBAR) provides an excellent framework for communication in daily resident handoffs.

Objective: To evaluate implementation of SBAR into the surgical curriculum.

Design: A curriculum using video and role-play scenarios to augment a didactic lecture on SBAR was implemented for general surgery residents.

Factors that predict outcome of abdominal operations in patients with advanced cirrhosis.

Background & Aims: Patients with cirrhosis have an increased risk of complications during surgery that is relative to the severity of liver disease; it is a challenge to determine which patients are the best candidates for surgery. We performed a hospital-based study to identify factors that might facilitate selection of operative candidates and guide their management.

Methods: A retrospective review was performed of 100 cirrhotic patients (50 classified as Child-Turcotte-Pugh [CTP] A, 33 as CTP B, and 17 as CTP C) who underwent abdominal surgery at an institution specializing in liver medicine and transplant from 2002-2008.

Current recommendations on diagnosis and management of right-sided diverticulitis.

We present the case of a 52-year-old female with recurrent symptomatic ascending colon diverticulitis who ultimately underwent elective laparoscopic right hemicolectomy. The following is a case report and literature review pertaining to right colonic diverticular disease.

Management of hernias in pregnancy.

Background: Even though groin and umbilical hernias are rare in adult women, the rarer cases of pregnant women presenting with hernias create distinct challenges to treatment planning. The course of hernias in pregnant women, the effect of hernias on delivery, and the timing of elective herniorrhaphy have not been established. To date, there have been no published series establishing that postpartum repair of umbilical and groin hernias that develop in pregnancy is safe and acceptable.

Postoperative pain after laparoscopic ventral hernia repair: a prospective comparison of sutures versus tacks.

Background And Objectives: Mesh fixation in laparoscopic ventral hernia repair typically involves the use of tacks, transabdominal permanent sutures, or both of these. We compared postoperative pain after repair with either of these 2 methods.

Methods: Patients undergoing laparoscopic ventral hernia repair at the Mount Sinai Medical Center were prospectively enrolled in the study.

Recurrence after laparoscopic ventral hernia repair: a prospective pilot study of suture versus tack fixation.

Mesh fixation in laparoscopic ventral hernia repair requires the use of tacks and/or permanent transabdominal sutures. Sutures pass through all fascial and muscle layers of the anterior abdominal wall, whereas tacks secure the mesh simply to peritoneum. Controversy exists regarding the optimal fixation method.

Non-physician practitioners' overall enhancement to a surgical resident's experience.

Purpose: The Mount Sinai Surgical Residency program uses physician assistants and nurse practitioners, jointly termed non-physician practitioners (NPPs), to adhere to the 80-hour work-week restrictions implemented by Accreditation Council of Graduate Medical Education (ACGME) resident duty hour requirements initiated in 2003. A survey was performed to determine how the integration of NPPs into the surgical subspecialty teams has affected surgical residents' perceptions of their education and overall residency experience. We review the roles of NPPs within surgical specialty teams as well as our survey findings about NPP and resident impressions about the NPP role.