Attitudes and Habits of Highly Humanistic Surgeons: A Single-Institution, Mixed-Methods Study.

Purpose: Humanism in medicine is associated with increased patient satisfaction, trust of patients in their doctors, and better outcomes. The authors sought to identify attitudes, habits, and other factors that sustain humanism in academic surgical faculty, and compare these with attributes determined from a previous study of internal medicine faculty.

Method: A mixed-methods study design at University of Pennsylvania Health System was employed from 2016 to 2018 using a survey instrument and semistructured interviews.

A novel treatment approach to H-type esophageal lung in presence of pulmonary artery sling with pneumonectomy and intrathoracic tissue-expander placement.

Congenital tracheal anomalies occur in 1:10,000 births and can be associated with congenital cardiac disease. This patient presented with right mainstem atresia, right bronchoesophageal fistula without esophageal atresia (H-type esophageal lung), and left pulmonary arterial (PA) sling. Taking this into consideration, surgical management included right pneumonectomy and placement of expandable prosthesis into the thoracic cavity to buttress the mediastinum and prevent tracheal deviation-induced kinking of the PA sling, which provided pulmonary blood flow to the remaining functional lung.

Gastroschisis, atresia, dysmotility: surgical treatment strategies for a distinct clinical entity.

Purpose: Intestinal atresia (IA) occurs in 10% to 20% of infants born with gastroschisis (GS). We describe a distinct subset of these children with severe dysmotility, without mechanical intestinal obstruction, and with adequate intestinal length for enteral nutrition and propose possible treatment strategies.

Methods: A total of 177 patients with GS managed at a single institution between 1993 and 2007 were retrospectively reviewed.

Video-assisted thoracic surgery for primary spontaneous pneumothorax in children: is there an optimal technique?

Objective: Video-assisted thoracic surgery (VATS) for treatment of spontaneous pneumothorax refractory to nonoperative management was first reported in children by Rodgers in 1986 (Ann Surg. 1986; 204:677-680). Small series have shown success with apical blebectomy, mechanical or chemical (talc) pleurodesis, or combination techniques.

Evolution of the surgical management of neonatal ovarian cysts: laparoscopic-assisted transumbilical extracorporeal ovarian cystectomy (LATEC).

Purpose: Since its first detailed description in 1995, the laparoscopic management of neonatal ovarian cysts has typically required multiple incisions, specialized equipment, and advanced laparoscopic skills. After some initial frustration with neonatal laparoscopy, we developed a simplified single-incision laparoscopic-assisted transumbilical extracorporeal cystectomy (LATEC). This paper reviews our experience with this technique and compares outcomes to those of our other surgically managed neonatal ovarian cyst patients.

Beware of the flaming hairball--a brief review and warning.

Operating room fires are receiving increasing attention in the medical literature and in the general public. The best way to reduce these iatrogenic, sometimes devastating, events is communication and education. The authors present the case of a 14-year-old adolescent girl who had an apparent explosive event during a laparotomy for removal of a large gastric trichobezoar.