Robotic unroofing of myocardial bridge of the left anterior descending coronary artery in a patient with hypertrophic obstructive cardiomyopathy and previous septal myectomy.

Unlabelled: A 56-year-old female diagnosed with hypertrophic obstructive cardiomyopathy and myocardial bridge (MB) of the left anterior descending (LAD) coronary artery underwent septal myectomy with resolution of her left ventricular outflow tract gradient. She had ongoing refractory symptoms of exertional angina and fatigue for over a decade and finally presented to our clinic to be re-evaluated for treatment. Provocative angiographic testing confirmed significant ischemia secondary to LAD MB.

Routine External Iliac Artery Cannulation in Robotic Cardiac Surgery: Role of the Corona "Vitae" in Distal Limb Perfusion.

Objective: Femoral artery cannulation is the most commonly used approach for cardiopulmonary bypass (CPB) in robotic cardiac procedures. However, without adding a distal perfusion cannula, leg ischemia can occur in up to 11.5% of patients.

Inexpensive and Easy to Set Up Robotic Cardiac Simulator Offers "Unlimited" Endoscopic Coronary Artery Bypass Grafting Experience: Proof of Concept.

Objective: Robotic totally endoscopic coronary artery bypass (TECAB) grafting is the least invasive form of coronary bypass surgery. However, despite its advantages, this approach has not gained widespread adoption. One possible reason is the advanced and complex robotic skills required to execute a totally endoscopic sutured coronary anastomosis.

Evaluation of the Educational Value of Low-Cost Training Model for Emergency Cricothyrotomy.

Background: In this study, we aimed to evaluate the educational value and students' satisfaction with the hand-made low-cost cricothyrotomy simulation model.

Materials And Methods: A low-cost and hand-made model and a high-fidelity model were used to assess the students. The students' knowledge and satisfaction were evaluated using a 10-item checklist and a satisfaction questionnaire, respectively.

Evaluating Non-operative Robotic Skills in Colorectal Surgical Training.

Background: Robotic-assisted surgery has become a common platform for performing colorectal procedures. Educators must determine how best to teach and train residents to use the technology safely. There is a paucity of literature on how non-operative skills are being taught and integrated into colorectal training.

International Medical Graduates are Comparable to American Medical Graduates as General Surgery Interns.

Background: International medical graduates (IMGs) are often relegated to preliminary positions in general surgery (GS) owing to uncertainties about the candidate's performance in the American healthcare setting. We aimed to determine the comparative performance of IMGs and American medical graduates (AMGs) at baseline and assess these trends over the course of their GS internship.

Methods: Evaluations of all IMG preliminary and AMG categorical interns from 2013 to 2017 at our GS residency program were obtained from three faculty members to score overall performance, technical skills, interpersonal communication, and medical knowledge on a 10-point Likert scale.

Value of Research Years for International Medical Graduates Applying to General Surgery Residency.

Objective: While dedicated research time (DRT) offers international medical graduates (IMGs) exposure to the US healthcare system and helps boost their residency application, it can lengthen time away from clinical activity. We aimed to determine the value of DRT/protected research time for an IMG applying to general surgeryresidency (GSR).

Design: Cross-sectional survey.

Group Video Feedback is an Effective and Efficient Tool for Enhancing Skills of Surgical Interns.

Background: Our group has shown that personalized video feedback (PVF) is better than a task demonstration video at increasing wound closure skills among incoming surgical interns. However, offering PVF can be time-consuming. We sought to compare the educational effects and time required for group video feedback (GVF) and PVF.

A Simulation Suture Compared With a Clinical Suture for Training on Laparoscopic Simulators: Objective Measurements Indicate Acceptable Physical Characteristics.

Objective: Simulation sutures are a low-cost option for training purposes, but they may not perform as well as the more expensive clinical suture. Trainees at our institution have raised concerns about their quality and integrity compared with clinical suture. The objective was to determine whether significant differences in strength of the sutures and knot holding capabilities between low and high-cost sutures existed.

A simulation-based selection process for trying to identify medical students who will become outstanding general surgery residents.

Background: Selecting the right applicants for general surgery training is critical and difficult. We refined our selection process by using a pre-interview preparation package and simulation-based assessments.

Methods: Sixty applicants invited for categorical general-surgery residency interview were mailed an educational package which included a link to instructional videos, surgical instruments and low-cost models for suturing, open knot tying, and adrenal anatomy knowledge.

Can the Perceived Difficulty of a Task Enhance Trainee Performance?

Background: Human understanding of how to efficiently train learners in procedural skills is imperfect. The concept of self-efficacy - confidence in one's ability to successfully complete a task - may be useful to learners. Theories of motivation and instructional design suggest there are specific targets for improving learner success.

A black esophagus as a result of treatment of inferior vena cava occlusion by a massive pelvic schwannoma.

This case presentation involves a 57-year-old-male who suffered multiple adverse sequels from the delayed diagnosis of a large presacral mass. He initially presented with lower extremity deep vein thrombosis (DVT). Several months later, he had developed a pulmonary embolus.

An Inexpensive, Portable Physical Endoscopic Simulator: Description and Initial Evaluation.

Background: Surgeons and gastroenterologists in training benefit from simulation-based endoscopy education, yet the price of most training endoscopy simulators is prohibitive. We set out to create and evaluate a low-cost endoscopic simulator and box model trainer for learning fundamental endoscopic skills.

Methods: After adding a wireless network-enabled camera (total cost, $20) to a discarded clinical endoscope, we paired this with an easily constructed box trainer (cost $32) to generate an endoscopic simulator system (YazanoScope) for simulation training.

Making EPAs a 59 minute objective measure for surgical trainees - A pilot study.

Introduction: Accurately confirming surgical trainees have met the requirements of entrusted professional activities (EPAs) will require rigorous staff input. We pondered whether such simulation-driven evaluations might prove useful to the current ABS/APDS pilot effort on EPA analysis.

Methods: Our surgical trainees participate biannually in a 59-min simulation-based assessment (X-Games) which covers surgical technique, knowledge and critical thinking in a host of domains.

Outcomes of laparoscopic and open CAPD catheter placement: A single-center experience.

Background: Continuous Ambulatory Peritoneal Dialysis (CAPD) catheter placement is typically a straightforward surgical procedure performed on chronically ill patients with end-stage renal disease (ESRD). Post-operative outcomes and reoperative rates vary greatly in the medical literature. We report our experience using both minimally invasive and open techniques in placing CAPD catheters and offer our surgical outcomes.

Low-cost materials yield high resolution assessment of anatomic knowledge in surgical residents.

Introduction: Knowledge of anatomy is essential for surgeons. We sought to determine whether it is possible to effectively assess and differentiate the anatomic knowledge of general surgery residents, using pieces of fabric and yarn.

Methods: Postgraduate years 2, 3, and 4 general surgery residents were assessed during a simulation-based assessment known as the Surgical X-Games.

Surgical interns in 2018: Objective assessment suggests they are better but still lack critical knowledge and skill.

Background: The transition from fourth-year medical student to surgical intern is difficult. A lack of repetitions, experience, and knowledge is problematic. We report our experience using simulation-based technical and nontechnical skills to assess the competency of surgical interns in July and January of their intern year.

Supporting self-regulation in simulation-based education: a randomized experiment of practice schedules and goals.

Self-regulated learning is optimized when instructional supports are provided. We evaluated three supports for self-regulated simulation-based training: practice schedules, normative comparisons, and learning goals. Participants practiced 5 endoscopy tasks on a physical simulator, then completed 4 repetitions on a virtual reality simulator.

Factors that Predict an Intern's First ABSITE Score are Known by September.

Background: Previous studies offer conflicting relevance of a variety of factors to predict resident performance on the The American Board of Surgery In-Training Exam (ABSITE). With numerous stellar applicants scoring poorly on their first ABSITE, we sought to identify key factors that might allow us to tailor pre-emptive study efforts in the fall and early winter to enhance scores.

Methods: General Surgery residents in our program from 2009 through 2016 were included in our cohort study.

The FES Test: Are We Ready?

Purpose: The FES hands-on skills test is administered using a $100,000 computer-based simulator. Few of our trainees have practiced on this device. Our aim was to evaluate our GS residents' baseline endoscopic skills and eventually develop a simulation-based endoscopy curriculum and clarify performance-based assessment criteria.

Correlation of Objective Assessment Data With General Surgery Resident In-Training Evaluation Reports and Operative Volumes.

Objective: Faculty evaluations, ABSITE scores, and operative case volumes often tell little about true resident performance. We developed an objective structured clinical examination called the Surgical X-Games (5 rooms, 15 minutes each, 12-15 tests total, different for each postgraduate [PGY] level). We hypothesized that performance in X-Games will prove more useful in identifying areas of strength or weakness among general surgery (GS) residents than faculty evaluations, ABSITE scores, or operative cases volumes.

Maximum cosmesis for patients with primary hyperparathyroidism: a case for larger incisions.

While minimally invasive parathyroidectomy is an advantage to many properly selected patients, longer incisions and even wide skin resection may be optimal in a select few. We present an 80-year-old woman with primary hyperparathyroidism and bothersome excess neck skin and subcutaneous fat. The parathyroid adenoma was easily excised through a vertically-oriented cervical excision that removed an ellipse of fat and skin.

Cadaveric Dissection vs Homemade Model: What is the Best Way to Teach Endoscopic Totally Extraperitoneal Inguinal Hernia Repair?

Background: Endoscopic totally extraperitoneal inguinal hernia repair (TEP-IHR) requires practice and training to perform well. We developed a simple, low-cost, inanimate model to teach surgical residents inguinal anatomy and the technique of mesh insertion for a safe, endoscopic TEP-IHR. The objective of this study was to compare our model vs cadaveric dissection for teaching anatomy and mesh insertion.