Bariatric surgery in a public hospital: a 10-year experience.

Introduction: Obesity is common and adversely impacts quality-of-life and healthcare cost. In Australia, less than 10% of bariatric surgeries are performed in the public sector. This study reports our 10-year experience from a high volume public bariatric service which delivers multi-disciplinary care for primary and revisional procedures with mid- to long-term follow-up.

Development of an International Standardized Curriculum for Laparoscopic Sleeve Gastrectomy Teaching Utilizing Modified Delphi Methodology.

Background: The performance of laparoscopic sleeve gastrectomy has increased markedly to become the single-most performed bariatric surgical procedure globally. To date, a means of standardized trainee teaching has not been developed. The aim of this study was to design a laparoscopic curriculum for trainees of bariatric surgery utilizing modified Delphi consensus methodology.

Video-Rated Performance Assessment of Simulated Laparoscopic Sleeve Gastrectomy: Validation of a Sleeve Gastrectomy Rating Scale.

Purpose: The global rise in obesity has been accompanied by widespread uptake of the procedure of laparoscopic sleeve gastrectomy. Despite this, the key components for performance assessment have not been standardized for this procedure. The aim of this study was to develop and demonstrate the validity of a Sleeve Objective Structured Assessment of Technical Skill (SOSATS) scale for learning the procedure of laparoscopic sleeve gastrectomy (LSG).

Laparoscopic sleeve gastrectomy in a patient with and Kartagener syndrome: an unusual surgical conundrum.

Kartagener syndrome is a rare autosomal recessive condition. Approximately 25% of those with suffer the syndrome. With the rising overall number and indications for bariatric surgery, this condition will be increasingly recognised.

Giant perforated marginal ulcer after laparoscopic -en-Y gastric bypass.

Perforation of a marginal ulcer (MU) is a complication of -en-Y gastric bypass that can be life-threatening. We report a case of a perforated MU that presented 7 months after surgery with several interesting points for discussion. Firstly, the presentation of the ulcer was cryptic with unreliable investigations.

A short course for surgical supervisors and trainers: effecting behavioural change.

Background: The Supervisors and Trainers for the Surgical Education and Training (SAT SET) course was developed to assist surgical trainers in Australia and New Zealand with the transition to the new Surgical Education and Training framework. The aim of this study was to assess whether attendance at the course translated into behavioural change in surgical trainers and supervisors.

Methods: An online survey tool was distributed to registered participants in the SAT SET Course.

Salutary swan song for the Starr Edwards valve.

The Starr-Edwards valve was the first manufactured valve to be used successfully as a cardiac valve replacement in 1960. Although superseded by newer valves over the decades it has achieved an excellent track record. It has unique features, namely a protective metal casing around the ball poppet and a large and thick sewing ring.

Thrombus straddling an atrial septal defect: surgical prevention of massive pulmonary and systemic embolization.

A large thrombus entrapped in an atrial septal defect is a rare condition that can lead to life-threatening systemic and pulmonary embolization. The use of thrombolysis may prove dangerous to the patient. Herein, we describe the emergency surgical management that contributed to a successful outcome in a 67-year-old man who was found to have a 23-cm-long thrombus across an atrial septal defect.

Complex coronary sinus fistula in a 58-year-old female.

Coronary artery aneurysms and arterio-venous fistulae are uncommon malformations. We report the case of a 58-year-old woman with a large aneurysmal fistula arising from the left coronary tree and involving the entire coronary sinus venous system, resulting in significant left-to-right shunt. We discuss the management of aneurysmal fistulae of the coronary arteries, and the merits of prophylaxis for thrombotic complications of large aneurysms.

Eliminating the limitations of manual crimping in stapes surgery: mid-term results of 90 patients in the Nitinol stapes piston multicenter trial.

Objective: To present our mid-term results of our multicenter study using the Nitinol self-crimping stapes piston, focusing on the interindividual variations of postoperative air-bone gap closures (ABGC), postoperative hearing results, and postoperative recurrences of conductive hearing loss and to compare these findings with our pilot group of patients.

Study Design: Prospective, multicenter cohort study involving three academic tertiary care referral centers from Australia, Switzerland, and the United States.

Methods: Ninety patients with otosclerosis undergoing laser-stapedotomy with the Nitinol stapes piston were matched to reference patients from our titanium piston database.

Prevocational medical training and the Australian Curriculum Framework for Junior Doctors: a junior doctor perspective.

The current system of prevocational training does not meet the needs of junior doctors because of a high administrative workload, insufficient funding for education, and a lack of centralised guidance for trainees, teachers and hospitals. The Australian Curriculum Framework for Junior Doctors is designed to identify the training objectives for the prevocational years. The Framework has the potential to improve the quality of training of junior doctors, but this depends on how well it is implemented and resourced.

Second branchial cleft sinus presenting after adenotonsillectomy.

Branchial cleft sinuses are one of the more common congenital defects arising in the head and neck region. Second branchial cleft anomalies are the commonest of the true branchial cleft defects and the diagnosis is usually straightforward. We report the case of an atypical presentation of branchial cleft sinus that manifested after adenotonsillectomy.