Translating motion tracking data into resident feedback: An opportunity for streamlined video coaching
Publication date: Available online 21 January 2020Source: The American Journal of SurgeryAuthor(s): Kenneth H. Perrone, Su Yang, Hossein Mohamadipanah, Brett Wise, Anna Witt, Cassidi Goll, Carla PughAbstractBackgroundWe hypothesized that differences in motion data during a simulated laparoscopic ventral hernia repair (LVH) can be used to stratify top and lower tier performers and streamline video review.Materials and methodsSurgical residents (N = 94) performed a simulated partial LVH repair while wearing motion tracking sensors. We identified the top ten and lower ten performers based on a final product quality score (FPQS) of the repair. Two blinded raters independently reviewed motion plots to identify patterns and stratify top and lower tier performers.ResultsTop performers had significantly higher FPQS (23.3 ± 1.2 vs 5.7 ± 1.6 p
ConclusionPre-peritoneal drainage is clinically safe in laparoscopic totally extra-peritoneal hernioplasty and can effectively reduce the size and incidence of seroma. The seroma formation can be further reduced by appropriate use of monopolar energy as preferred dissection approach in lap TEP. Due to limitation in measuring the actual energy time, the result should be further validated by randomized multi-centers trial on its potential benefit in hernia repair by a more accurate measuring device on energy used.
Publication date: Available online 14 February 2020Source: Journal of Visceral SurgeryAuthor(s): M. Neuberg, M.C. Blanchet, V. Frering, B. Darnis, B. Gignoux
GERD is a spectrum disorder, and treatment should be individualized to the patient ’s anatomic alterations. Trans-oral incisionless fundoplication (TIF 2.0) is an endoscopic procedure which reduces EGJ distensibility, thereby decreasing tLESRs, and also creates a 3-cm high pressure zone at the distal esophagus in the configuration of a flap valve. As it produces a partial fundop lication with a controlled valve diameter, gas can still escape from the stomach, minimizing the side-effect of gas-bloat. Herein we discuss the rationale, mechanism of action, patient selection, step-by-step procedure, safety and efficacy da...
Condition: Congenital Hernia Intervention: Other: hernia repair Sponsor: Al-Azhar University Completed
AbstractBackgroundWe aimed to examine the outcomes and utilization of different hiatal hernia repair (HHR) approaches in elective and emergent/urgent settings. Methods: Vizient 2015 –2017 database was queried for adult patients who underwent HHR. Patients were grouped into open (OHHR), laparoscopic (LHHR), or robotic-assisted (RHHR), and further stratified by elective or urgent status and severity of illness at admission. Surgical outcomes and costs were compared across all g roups. Statistical analysis were done using SPSS v.25.0.Results9171 adults were included (OHHRN = 1534;LHHRN = 6796...
ConclusionParticipants with better hernia repair outcomes engaged in more operative management communication during the simulated procedure. This ability to integrate multiple operative steps and verbally communicate them significantly correlated with better operative outcomes.
ConclusionSurgeons performing laparoscopic excisional biopsy of the diaphragmatic peritoneum should consider the potential risk for iatrogenic diaphragmatic hernias.
ConclusionWe successfully performed single-incision retroperitoneal laparoscopic repair of superior lumbar hernia using self-fixating mesh.
AbstractBackgroundMesh repair of parastomal hernia is widely accepted as superior to non-mesh repair, yet the most favorable surgical approach is a subject of continued debate. The aim of this study was to compare the clinical outcomes of open versus laparoscopic parastomal hernia repair.MethodsAn IRB-approved retrospective review was conducted comparing laparoscopic (LPHR) or open (OPHR) parastomal hernia repair performed between 2009 and 2017 at our facilities. Patient demographics, preoperative characteristics, operative details, and clinical outcomes were compared by surgical approach. Subgroup analysis was performed b...
Antireflux surgery is challenging, and has become even more challenging with the introduction of alternative endoscopic and laparoscopic options for patients with gastroesophageal reflux disease (GERD). The Nissen fundoplication remains the gold standard for the durable relief of GERD symptoms and esophagitis. All antireflux procedures have a failure rate, and it is important to minimize factors that are associated with failure. The selection of patients for antireflux surgery as well as the choice of the procedure requires a thorough understanding of esophageal physiology and the pros and cons of various options.