Is it possible to return to skiing following long-construct spinal deformity surgery?

Background: Alpine skiing requires flexibility, endurance, strength and rotational ability, which may be lost after long fusions to the pelvis for adult spinal deformity (ASD). ASD patients may worry about their ability to return to skiing (RTS) postoperatively. There is currently insufficient data for spine surgeons to adequately address questions about when, or if, their patients might RTS.

The impact of a secondary, rare, non-pathogenic PKD1 variant on disease progression in autosomal dominant polycystic kidney disease.

Background: Autosomal dominant polycystic kidney disease (ADPKD) is caused primarily by pathogenic variants in the PKD1 and PKD2 genes. Although the type of ADPKD variant can influence disease severity, rare, hypomorphic PKD1 variants have also been reported to modify disease severity or cause biallelic ADPKD. This study examines whether rare, additional, potentially protein-altering, non-pathogenic PKD1 variants contribute to ADPKD phenotypic outcomes.

Undervaluation of Perioperative Work for ACL Reconstruction by Relative Value Scale Update Committee Methodology in a Single Surgeon's Practice.

Objectives: The purpose of this study was to determine the accuracy of the Relative Value Update Committee (RUC) and Centers for Medicare & Medicaid Services current times and work relative value units (wRVUs) for the perioperative work involved in anterior cruciate ligament (ACL) reconstruction by directly timing perioperative tasks as they occur in real time.

Methods: The RUC was contacted to obtain a list of perioperative tasks and the corresponding times allotted for the tasks involved in arthroscopically aided ACL reconstruction (Current Procedural Terminology code 29888). The tasks that occurred both inside and outside the operating room were timed by the attending physician as the event occurred.

Management of adhesive small bowel obstruction during pregnancy in the United States.

Background: Adhesive small bowel obstruction (ASBO) is a rare, nonobstetrical abdominal emergency. Optimal management of ASBO during pregnancy remains unknown. This study analyzes management trends and outcomes of pregnant patients with ASBO in the United States.

Delayed Superficial Temporal Artery Pseudoaneurysm Following Minor Trauma in a Post-facelift Patient.

A 37-year-old woman with a history of facelift surgery presented with a painless temporal mass after surfboard trauma. Physical examination revealed a 1 cm pulsatile mass, and ultrasound confirmed a superficial temporal artery pseudoaneurysm. Surgical excision was complicated by adhesions from previous facial surgery and steroid injections.

Robotic-Assisted Medial Unicompartmental Knee Arthroplasty in an Outpatient Setting.

There were 63 outpatient medial unicompartmental knee arthroplasties (UKAs) performed by Mako robotic assistance by six surgeons. There were 40 men and 23 women who had a mean age of 65.1 years (range, 38 to 80).

Ventral Rectopexy: An International Expert Panel Consensus and Review of Contemporary Literature.

Background: Ventral rectopexy has become increasingly utilized in the surgical management of rectal prolapse. There is a need for a contemporary evaluation of the role of the procedure and description of its use in clinical practice.

Objective: To create an international consensus on ventral rectopexy.

Long-term Outcomes After Minimally Invasive Ventral Rectopexy for Rectal Prolapse Using Biologic Graft Prosthesis: A 15-Year Retrospective Cohort Study.

Background: Minimally invasive ventral rectopexy has widely become the preferred prolapse procedure. However there have been recent concerns regarding the safety of permanent synthetic mesh in the pelvis. Biologic grafts have also been commonly used as an alternative prosthesis, but data on their safety and the longevity of the prolapse repair have been lacking.

Brief Ectopic Banking and Immediate Plate Fixation With Free Omental Flap Addresses Multiple Fundamental Problems for Single-Stage Replant of Transhumeral Amputation.

High-velocity traumatic amputations of the proximal upper extremity are devastating to the patient and represent an extreme surgical challenge to the treatment team. The hand surgeon must simultaneously battle devascularization with timely microvascular anastomosis, gross contamination with meticulous debridement, and amputation with stable fixation. In restoring a functional extremity, many of these goals are in contention with each other.

Challenges and complications in arthroscopic ankle ligament repair: Current concepts.

Arthroscopic ligament repair has gained popularity as a minimally invasive alternative for addressing ankle instability, due to its minimally invasive nature, which offers significant advantages over traditional open procedures. These benefits include smaller incisions, reduced soft tissue dissection, and the ability to concurrently manage intra-articular pathology, contributing to its popularity among surgeons and patients alike. Despite these advantages, the procedure presents a range of technical challenges and potential complications that can impact patient outcomes.

Impact of Anti-Fatigue Floor Mat on Surgical Staff Comfort Levels in Head and Neck Surgery Cases.

Objective: Musculoskeletal symptoms are common among surgical staff and can have long-term implications on health and wellbeing. The purpose of this study is to evaluate the impact of anti-fatigue floor mat on the comfort level of surgical teams during head and neck surgeries lasting ≥ 3 h.

Methods: Over 4 months, we prospectively randomized 34 major (≥ 3 h) head and neck procedures to the use or not of an anti-fatigue floor mat.

Mental Health and Wellness Among Plastic Surgeons During Oral Board Certification Examination Preparation.

Background: The field of plastic and reconstructive surgery has recently made a dramatic shift toward attention to mental health, with residency curricula expanding to include training on burnout prevention and the promotion of well-being. After graduation, however, new surgeons face a difficult year of preparation for the oral board certification examination. This group of young surgeons remains largely unstudied and undersupported throughout what may be the most challenging period of their educational journey.

Plastic Surgeon Well-being, Mindfulness, and the Art of Letting Go.

As plastic surgeons, we strive to achieve the best possible outcomes for our patients. However, despite being a good surgeon with a sound plan that was thoughtfully crafted and well executed, complications still happen. As a result, surgeons involved in the care of patients who have complications can experience mental and emotional suffering, including feelings of guilt, sadness, anxiety, and stress.

Mentorship in Plastic Surgery: A Systematic Review of the Current Literature and Elucidation of Recurring Themes.

Background: Mentorship is an integral part of developing competent, passionate, and successful plastic surgeons and is an important element of surgeons' wellness. Although mentorship programs have been described in the literature, this study aimed to elucidate the specific qualities of an effective mentor in plastic surgery.

Methods: Preferred Reporting Items for Systematic Reviews and Meta-analyses methodology was utilized to conduct a systematic review of the literature.

Introduction to the Wellness Mini-series. Burnout, Disengagement, and Other Psychological Quagmires: It's Not All in Your Head.

Surgery is a state of mind. The brain controls the hands. As a result, "technical skills" are more mental than technical.

The Intersection of a Life Partner and Professional Wellness for the Plastic Surgeon.

Our literature review describes the complicated intersection of the physician/surgeon's professional practice and their spouse/domestic partner, acknowledging that the existing literature specific to plastic surgeons is limited. Nevertheless, the broader research of physicians and other surgical fields identifies many risk factors for work-home conflicts, which can negatively impact the surgeon and the spouse. Furthermore, certain studied groups have other unique challenges and considerations, such as women surgeons, residents, and dual-physician couples.

Practicing Emotional Self-awareness to Build Surgeon Resilience.

As surgeons, we work in a high-stress, high-stakes environment to take care of our patients. In this setting, it is not uncommon for us to experience microaggressions-subtle or indirect actions or statements that communicate a demeaning or exclusionary message, often unintentionally. Microaggressions can bring us down, taking away from the fulfillment that attracted many of us to this profession.

Importance of Exercise for Career Longevity: Maintaining Fitness, Strength, and Flexibility as a Plastic Surgeon.

The benefits of exercise for the general population are well established, although there is limited information focusing on its importance for plastic surgeons. Plastic surgery is arguably one of the most physically taxing fields within medicine due to lengthy operations that often require putting oneself in uncomfortable positions for the majority of the case, all while maintaining mental focus and discipline. It is essential to incorporate regular routines that can optimize a plastic surgeon's mental and physical capacity both short- and long-term.

Coping With Microaggressions and Gaslighting in the Surgical Learning Environment.

Plastic surgery and plastic surgical training programs are institutions rife with rewards. However, these rewards can be tempered by general physical and psychosocial stressors inherent to a surgical specialty. Although progress has been made in addressing the physical demands of training, less attention is given to the psychosocial and interpersonal challenges faced by plastic surgeons and trainees.

Career Planning and Maintaining Well-being in Academic Plastic Surgery.

Success in academic plastic surgery is based on the traditional pillars of promotion: clinical excellence, teaching, research, leadership, and service to the university and community. The time commitment and workload for career advancement are highly demanding and, therefore, well-being is essential to avoid burnout. A congruent healthy work environment that meets institutional goals and surgeons' objectives can be established through inclusive, transparent, strategic, and operational planning.