Publications by authors named "Michael de Virgilio"
Background: Symptomatic cholelithiasis is a common surgical disease and accounts for half of the over one million cholecystectomies performed in the USA annually. Despite its prevalence, only one prior systematic review has examined the evidence around treatment strategies and it contained a narrow scope. The goal of this systematic review was to analyze the clinical effectiveness of treatment options for symptomatic cholelithiasis, including surgery, non-surgical therapies, and ED pain management strategies.
View Article and Find Full Text PDFBackground: Gallstones are a common problem in the United States with many patients suffering from symptomatic cholelithiasis (SC). Patients with SC may first present to the emergency department ED) and are often discharged for elective follow-up; however, it is unknown what system and patient factors are associated with increased risk for ED revisits. This study aimed to assess longitudinal ED utilization and cholecystectomy for patients with SC and identify patient, geographic, and hospital characteristics associated with ED revisits, specifically race/ethnicity and insurance status.
View Article and Find Full Text PDFBackground: Timely receipt of surgery should be available for all patients. Few studies have examined differences in the treatment of symptomatic cholelithiasis (SC), a common surgical problem, based on race/ethnicity or insurance status. This study aimed to identify differences in repeat emergency department (ED) use and wait time to cholecystectomy for SC.
View Article and Find Full Text PDFIntroduction: The use of the robot in general surgery has exploded in the last decade. The Veterans Health Administration presents a unique opportunity to study differences between surgical approaches due to the ability to control for health system and insurance variability. This study compares clinical outcomes between robot-assisted and laparoscopic or open techniques for three general surgery procedures.
View Article and Find Full Text PDFIntroduction: Risk factors for interpersonal violence-related injury (IPVRI) in low-income and middle-income countries (LMICs) remain poorly defined. We describe associations between IPVRI and select social determinants of health (SDH) in Cameroon.
Methods: We conducted a cross-sectional analysis of prospective trauma registry data collected from injured patients 15 years old between October 2017 and January 2020 at four Cameroonian hospitals.
Article Synopsis
- Robotic ventral hernia repair (VHR) is becoming more common, but research comparing its effectiveness and cost to other methods like laparoscopic and open surgery is limited.
- A systematic review analyzing 25 studies found that while robotic VHR took longer to perform, it resulted in fewer blood transfusions, shorter hospital stays, and lower complication rates compared to open surgery, but it was more expensive than laparoscopic repair.
- The study suggests that more comprehensive data is needed to fully understand the benefits and costs of robotic VHR in the long term.
Background: Multiple tools predicting massive transfusion (MT) in trauma have been developed but utilize variables that are not immediately available. Additionally, they only differentiate blunt from penetrating trauma and do not account for the large range of blunt mechanisms and their difference in force. We aimed to develop a Blunt trauma Massive Transfusion (B-MaT) score that accounts for high-risk blunt mechanisms and predicts MT needs in blunt trauma patients (BTPs) prior to arrival.
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- The study investigates the clinical outcomes of robot-assisted minimally invasive esophagectomy (RAMIE) compared to video-assisted minimally invasive esophagectomy (VAMIE) and open esophagectomy (OE) for treating esophageal cancer, due to the rising use of RAMIE despite limited comparative data.
- A systematic review was conducted, analyzing 21 studies that included nearly 9,355 patients, with a focus on various intraoperative and short- to long-term outcomes, following established reporting guidelines.
- The results showed RAMIE had a lower rate of pulmonary complications compared to VAMIE, but no significant differences in lymph node harvest, anastomotic leaks, or estimated blood loss were found between the two surgical methods.
With changes in work hour limitations, there is an increasing need for objective determination of technical proficiency. Electromagnetic hand-motion analysis has previously shown only time to completion and number of movements to correlation with expertise. The present study was undertaken to evaluate the efficacy of hand-motion-tracking analysis in determining surgical skill proficiency.
View Article and Find Full Text PDFBackground: The urgency of laparoscopic cholecystectomy for acute cholecystitis is under debate. We hypothesized that nighttime cholecystectomy is associated with decreased length of stay.
Methods: Retrospective review of 1,140 patients at 2 large urban referral centers with acute cholecystitis who underwent daytime (7 am to 7 pm) versus nighttime (7 pm to 7 am) cholecystectomy was conducted.
Background: Laboratory skills training is now required for general surgery residents. The optimal method of teaching vascular anastomosis (VA) is not well defined. Teaching VA skills one-on-one with a faculty instructor will result in a more rapid accumulation of skills than teaching in a large group setting.
View Article and Find Full Text PDFNecrotizing soft tissue infections (NSTIs) require prompt diagnosis and treatment. Early identification of patients at greatest risk of limb amputation and death may help in targeting aggressive medical and surgical management. The aim of this study was to assess predictors of limb loss and mortality in patients with NSTI based on admission variables.
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