Surgical management of obesity: current state of procedure evolution and strategies to optimize outcomes.

Surgical treatment of morbid obesity remains the most effective modality available. Procedures have evolved over the past 50 years and have utilized caloric restriction and malabsorption, alone or in combination. Optimizing outcome and preserving good nutrition health is the goal of the multidisciplinary care that these patients need.

The 80-hour work week: will we have less-experienced graduating surgeons?

Objective: Our primary concern when modifying the Mount Carmel Medical Center surgical residency to comply with the "80-hour work week" was the effect on operative experience. Our goal was to measure the impact that work-hour restrictions have on operative volumes and to evaluate the potential benefit of a night rotation to minimize the number of "lost operations."

Design: Categorical surgical residents (PGY I-IV) recorded missed surgical procedures on post-call days from September 1, 2002 to March 31, 2004.