A multi-institutional study from the US ROPE consortium examining factors associated with endocrine surgery exposure for general surgery residents.

Background: Prior analyses of general surgery resident case logs have indicated a decline in the number of endocrine procedures performed during residency. This study aimed to identify factors contributing to the endocrine operative experience of general surgery residents and compare those who matched in endocrine surgery fellowship with those who did not.

Methods: We analyzed the case log data of graduates from 18 general surgery residency programs in the US Resident Operative Experience Consortium over an 11-year period.

Disparities in the Operative Experience Between Female and Male General Surgery Residents: A Multi-institutional Study From the US ROPE Consortium.

Objective: To examine differences in resident operative experience between male and female general surgery residents.

Background: Despite increasing female representation in surgery, sex and gender disparities in residency experience continue to exist. The operative volume of male and female general surgery residents has not been compared on a multi-institutional level.

Racial and Ethnic Disparities in Operative Experience Among General Surgery Residents: A Multi-Institutional Study from the US ROPE Consortium.

Objective: To determine the relationship between race/ethnicity and case volume among graduating surgical residents.

Background: Racial/ethnic minority individuals face barriers to entry and advancement in surgery; however, no large-scale investigations of the operative experience of racial/ethnic minority residents have been performed.

Methods: A multi-institutional retrospective analysis of the Accreditation Council for Graduate Medical Education case logs of categorical general surgery residents at 20 programs in the US Resident OPerative Experience Consortium database was performed.

Do General Surgery Residents Begin Specializing Before Fellowship? A Multi-Institutional Study from the US ROPE Consortium.

Background: Single-center data suggest that general surgery residents perform more cases related to their future fellowship compared with their peers. This study aimed to determine whether this experience was true for residents across multiple programs.

Study Design: Data from graduates of 18 Accreditation Council for Graduate Medical Education (ACGME)-accredited general surgery residency programs in the US Resident OPerative Experience (ROPE) Consortium were analyzed.

Outcomes after anti-reflux procedures: Nissen, Toupet, magnetic sphincter augmentation or anti-reflux mucosectomy?

Background: Surgical treatment options of gastroesophageal reflux disease have changed significantly in the last 50 years. Magnetic Sphincter Augmentation (MSA) and Anti-reflux Mucosectomy (ARMs) are gaining traction but there is a paucity of literature comparing these novel options to Toupet fundoplication and gold standard Nissen fundoplication.

Methods: This is a retrospective review of a prospectively maintained database, evaluating patients undergoing Nissen, Toupet, MSA, and ARMs.

A multi-institutional study from the US ROPE Consortium examining factors associated with directly entering practice upon residency graduation.

Background: There is concern regarding the competency of today's general surgery graduates as a large proportion defer independent practice in favor of additional fellowship training. Little is known about the graduates who directly enter general surgery practice and if their operative experiences during residency differ from graduates who pursue fellowship.

Methods: Nineteen Accreditation Council for Graduate Medical Education-accredited general surgery programs from the US Resident OPerative Experience Consortium were included.

The Effect of Commonly Used Local Anesthetic on Bacterial Growth.

Introduction: Liposomal bupivacaine (LB) has emerged as a superior form of local anesthetic across numerous surgical subspecialties. The purpose of this study is to evaluate the ex-vivo antimicrobial effects of LB in comparison with traditional local anesthetics.

Methods: A standardized inoculum of bacteria commonly associated with surgical site infection was inoculated into a suspension of 1% lidocaine, 0.

Durability of per-oral endoscopic myotomy beyond 6 years.

 The aim of this study was to assess long-term clinical outcomes beyond 6 years in patients who underwent per-oral endoscopic myotomy (POEM) for the treatment of achalasia.  Patients with achalasia who underwent POEM between 2010 and 2012 and had follow-up of at least 6 years were retrospectively identified at eight tertiary care centers. The primary outcome evaluated was clinical success defined by an Eckardt symptom score (ESS) ≤ 3 for the duration of the follow-up period.

Using a standardized intra-operative endoflip protocol during fundoplication to identify factors that affect distensibility.

Introduction: The Endoluminal Functional Lumen Imaging Probe (Endoflip) can be used to provide objective measurements of the gastroesophageal junction during fundoplication, and recent publications have suggested that this device could improve surgical outcomes. However, the impact of operative variables has not been clearly reported. The aim of this study is to determine the effect of these variables on functional lumen imaging probe (FLIP) measurements.

Somatic DNA copy number alterations in non-dysplastic Barrett's esophagus.

Background: The purpose of this study was to analyze non-dysplastic Barrett's esophagus (NDBE) biopsy tissue and compare the rate of somatic DNA copy number alterations (CNAs) in patients who subsequently progressed to high-grade dysplasia (HGD) or esophageal adenocarcinoma (EAC) to those patients who did not.

Methods: A retrospectively collected database of Barrett's esophagus (BE) patients spanning a 16-year period was queried. Patients who progressed from NDBE to HGD or EAC were identified and compared to patients who did not.

Use of Impedance Planimetry (Endoflip) in Foregut Surgery Practice: Experience of More than 400 Cases.

Background: We provide a comprehensive report of our institution's experience with the endoluminal functional lumen imaging probe (Endoflip) impedance planimetry system, a device that can be used intraoperatively to objectively evaluate the distensibility of any sphincter of the gastrointestinal tract. We aim to describe the variety of ways in which the Endoflip can be used in a foregut surgeon's practice.

Study Design: This is a retrospective review of a prospectively maintained quality database of all patients in which the functional lumen imaging probe (FLIP) system was used between February 2013 and June 2019.

Using Impedance Planimetry (EndoFLIP) to Evaluate Myotomy and Predict Outcomes After Surgery for Achalasia.

Background: The functional lumen imaging probe (FLIP) is an innovative tool that uses impedance planimetry to assess esophageal geometry in real time. It has been used to diagnose achalasia and evaluate treatment failure after laparoscopic Heller myotomy (LHM) and peroral endoscopic myotomy (POEM). We hypothesize that impedance planimetry can be utilized intra-operatively to assess adequacy of myotomy and assist in predicting patient outcomes.

Endoscopic Suturing Results in High Technical and Clinical Success Rates for a Variety of Gastrointestinal Pathologies.

Purpose: We report our institution's experience with endoscopic suturing and hypothesize that it has high technical and clinical success.

Methods: This is a retrospective review of patients who underwent a procedure with the endoscopic suturing system between April 2010 and March 2019. Definitions of technical and clinical success were established for each application.

Laparoscopic inguinal hernia repair after prostatectomy: Evaluating safety, efficacy, and efficiency.

Background: For many surgeons, a prior prostatectomy is considered a contraindication to laparoscopic totally extraperitoneal hernia repair. This study aims to evaluate the safety, efficacy, and efficiency of totally extraperitoneal in these patients.

Methods: This is a review of a prospectively collected hernia database evaluating patients who underwent totally extraperitoneal repair between October 2009 and March 2018.

Five-year results of endoscopic gastrojejunostomy revision (transoral outlet reduction) for weight gain after gastric bypass.

Background: The study aim is to determine if patients who have undergone endoscopic gastrojejunostomy revision (EGJR) maintain weight loss up to 5 years postoperatively.

Methods: This is a retrospective review of patients who underwent EGJR with a full-thickness endoscopic suturing device between April 2009 and June 2018. Percent of excess body weight loss (%EBWL) was calculated using the weight on day of EGJR consult as baseline.

Using impedance planimetry (EndoFLIP™) in the operating room to assess gastroesophageal junction distensibility and predict patient outcomes following fundoplication.

Introduction: The purpose of this study is to evaluate the utility of using a functional lumen imaging probe (EndoFLIP™) intra-operatively during hiatal hernia repair and fundoplication. Additionally, we hypothesize that these measurements correlate with long-term outcomes.

Methods: A prospectively maintained quality database was queried.

Geriatric patients on antithrombotic therapy as a criterion for trauma team activation leads to over triage.

Background: Our institution amended its trauma activation criteria to require a Level II activation for patients ≥65 years old on antithrombotic medication presenting with suspected head trauma.

Methods: Our institutional trauma registry was queried for geriatric patients on antithrombotic medication in the year before and after this criteria change. Demographics, presentation metrics, level of activation, and outcomes were compared between groups.

Genetic variants in Barrett's esophagus and esophageal adenocarcinoma: a literature review.

Surveillance of Barrett's esophagus (BE) is a clinical challenge; metaplasia of the distal esophagus increases a patient's risk of esophageal adenocarcinoma (EAC) significantly but the actual percentage of patients who progress is low. The current screening recommendations require frequent endoscopy and biopsy, which has inherent risk, high cost, and operator variation. Identifying BE patients genetically who are at high risk of progressing could deemphasize the role of endoscopic screening and create an opportunity for early therapeutic intervention.

Intraductal Papillary Mucinous Neoplasm of the Pancreas Arising in the Setting of an Intermixed Acinar Cell Cystadenoma of the Pancreas: Report of a Rare Case.

Synchronous cystic lesions of the pancreas with different pathophysiology in the same patient are a rare occurrence.. We report the incidental finding of a multicystic lesion within the pancreatic head in a morbidly obese woman during workup for bariatric surgery.