Novel Computer-Aided Diagnosis Software for the Prevention of Retained Surgical Items
Retained surgical items are a serious human error. Surgical sponges account for 70% of retained surgical items. To prevent retained surgical sponges, it is important to establish a system that can identify errors and avoid the occurrence of adverse events. To date, no computer-aided diagnosis software specialized for detecting retained surgical sponges has been reported. We developed a software program that enables easy and effective computer-aided diagnosis of retained surgical sponges with high sensitivity and specificity using the technique of deep learning, a subfield of artificial intelligence. (Source: Journal of the...
Source: Journal of the American College of Surgeons - September 27, 2021 Category: Surgery Authors: Shun Yamaguchi, Akihiko Soyama, Shinichiro Ono, Shin Hamauzu, Masahiko Yamada, Toru Fukuda, Masaaki Hidaka, Toshiyuki Tsurumoto, Masataka Uetani, Susumu Eguchi Tags: Original scientific article Source Type: research

Impact of the WHO Surgical Safety Checklist Relative to Its Design and Intended Use: A Systematic Review and Meta-Meta-Analysis
The aim of this study was to identify what parts of the World Health Organization Surgical Safety Checklist (WHO SSC) are working, what can be done to make it more effective, and to determine if it achieved its intended effect relative to its design and intended use. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 27, 2021 Category: Surgery Authors: Kenji T. Sotto, Barbara K. Burian, Mary Brindle Tags: Collective Review Source Type: research

Long-Term Outcomes after Pediatric Injury: Results of the Assessment of Functional Outcomes and Health-Related Quality of Life after Pediatric Trauma Study
Among seriously injured children, discharge functional impairment was associated with continued functional impairment and lower health-related quality of life at 6 months. Other factors related to long-term functional impairment included older age, penetrating injury, severe head injury, and spine injury. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 27, 2021 Category: Surgery Authors: Randall S. Burd, Aaron R. Jensen, John M. VanBuren, Jessica S. Alvey, Rachel Richards, Richard Holubkov, Murray M. Pollack, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Netw Tags: Original Scientific Article Source Type: research

Ten-Year Outcomes of Children and Adolescents Who Underwent Sleeve Gastrectomy: Weight Loss, Comorbidity Resolution, Adverse Events, and Growth Velocity
This study aimed to analyze durability of weight loss and comorbidity resolution, growth velocity, and adverse events associated with laparoscopic sleeve gastrectomy (LSG) in children and adolescents with severe obesity. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 23, 2021 Category: Surgery Authors: Aayed R. Alqahtani, Mohamed Elahmedi, Hanan Y. Abdurabu, Sultan Alqahtani Tags: Original scientific article Source Type: research

Informed Decision-Making: Knowing Is Not the Same as Doing
Even when the knowledge exists that something should be done, there is not always proper follow-through. Surgical conversations are fraught with inadequate discourse on key points to appropriately inform and involve patients. Long and colleagues1 skillfully crafted a quantitative system to assess and score the ability of surgeons to cover elements of informed consent, as guided by the American College of Surgeons ’ definitions, and elements of informed decision-making, using a pre-existing validated scale. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Authors: Sean C. Wightman, Baddr A. Shakhsheer Tags: Invited commentary Source Type: research

Time to Stop and Pause
In 1995, Steven Strasberg described the critical view of safety (CVS) method of identifying ductal structures during laparoscopic cholecystectomy as 1 possible strategy to reduce the incidence of biliary injuries. Twenty-five years later, although progress has been made, biliary injury continues to be the most serious complication during this common operation.1 Of the 750,000 or more laparoscopic cholecystectomies performed in the US every year, the incidence of major bile duct injury remains at 0.2% to 0.3%, with a greater percentage of minor injuries or bile leaks that occur. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Authors: L Michael Brunt Tags: Invited commentary Source Type: research

Active Partnership for Pediatric Surgical Care
The article by Potts and colleagues, “Contemporary general surgery resident learning experience in pediatric surgery,”1 gives us an important portrayal of the current landscape of how we are training those likely destined to be adult general surgeons to care for children. The article notes 2 critically important issues with respect to the final product of our efforts to achieve general surgical competencies. The first is that there are more than 10,000,000 children living in rural America who do not have ready access to a fellowship-trained pediatric surgeon, and second, fellowship-trained pediatric surgeons ar...
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Authors: John HT. Waldhausen Tags: Invited commentary Source Type: research

Classic Ethical Dilemma: When Is it Acceptable to Treat Patients over Their Objection?
Informed consent is the foundation of the ethical practice of surgery. All surgeons are familiar with the ethical responsibility to obtain informed consent from patients or their appropriate surrogates before performing surgical procedures. Given this broad acceptance for respecting the autonomous choices of patients, which is manifested by the requirement for informed consent, how can it be that many patients undergo operations or have other interventions despite their objections to having the procedures? (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Authors: Peter Angelos Tags: Invited commentary Source Type: research

Divergent and Unified: A Path Forward for Firearm Injury Prevention
In the US, there are nearly 40,000 firearm-related deaths per year, or approximately 109 deaths per day.1 The firearm fatality rate has risen in recent years, and comprehensive prevention and treatment approaches led to a substantial decline in the fatality rate from motor vehicle crashes.2 In 2015, the American College of Surgeons (ACS) joined 7 other health professional organizations and the American Bar Association to issue a call to action for a public health approach to prevention of firearm injury and death. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Authors: Marian E. Betz, Maya Haasz Tags: Invited commentary Source Type: research

Value-Based Care for Gallstone Pancreatitis
Value-based care, or spending less money to achieve better health, should be the goal of all modern healthcare systems. Simply defined as the change in patient (or population) health outcomes divided by the cost to achieve the change, value is hard to measure and even more difficult to achieve.1 The benefit for patients, providers, hospitals, and society is clear: reduced cost for better outcomes, providers focusing on quality over quantity, and improving the economic sustainability of healthcare systems. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Authors: Patrick B. Murphy Tags: Invited commentary Source Type: research

Contents
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Source Type: research

Editorial Board
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 22, 2021 Category: Surgery Source Type: research

Analysis of Revenue, Expense, and Profitability in Surgical Procedures
The recent Journal of the American College of Surgeons article by Rosemurgy and colleagues1 entitled, “Cost Analysis of Pancreaticoduodenectomy at a High-Volume Robotic Hepatopancreaticobiliary Surgery Program,” tackles the difficult issue of evaluating profit from surgical procedures. The authors reconciled global payment for nonprofessional services with the cost of performing either robotic o r open pancreaticoduodenectomy to determine payor-specific profitability. As would be anticipated, there was significant variability in the payments received, with profitability in patients undergoing robotic pancreatic...
Source: Journal of the American College of Surgeons - September 18, 2021 Category: Surgery Authors: Lauren M. Perry, Richard J. Bold Tags: Letter Source Type: research

Vivien Thomas: The Unnamed Father of Atrial Septostomy
Vivien Thomas is a black man that is often only known for his contribution to the revolutionary Blalock-Taussig shunt used in “blue baby” operations. However, his contribution to the field of cardiac surgery goes beyond that. His fingerprints are all over the Blalock-Hanlon procedure, the antecedent to today’s balloon atrial septostomy. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 16, 2021 Category: Surgery Authors: Lukman Faniyi Tags: Special Article Source Type: research

Reducing Operating Room Cost: Comparing Attending and Surgical Trainee Perceptions About the Implementation of Supply Receipts
This study compares faculty and surgical trainees' perceptions about supply receipts and their effect on individual practice and cultural change. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 13, 2021 Category: Surgery Authors: Bradley S. Kushner, Bruce Hall, Andrew Pierce, Jessica Mody, Rebecca M. Guth, Jackie Martin, Jeffrey A. Blatnik, Shaina R. Eckhouse Tags: Original scientific article Source Type: research

Closing Thoughts Regarding Surgical Attire
I wish to commend Dr Svetanoff and colleagues on their stellar publication, “Debunking the myth on surgical site infection,” which appeared in the Journal of the American College of Surgeons, March 2021.1 The authors subsequently revisited this topic with yet another masterful contribution appearing in the July 2021 issue,2 Letters section.3 In both instances, they very clearly enumerate and illustrate the rigorous vetting required to generate bona fide actionable clinical recommendations. The precision logic by which the chaff is separated from the wheat provided highly educational and enjoyable reading. (Sour...
Source: Journal of the American College of Surgeons - September 13, 2021 Category: Surgery Authors: Patrick A. Cleary Tags: Letter Source Type: research

Effect of Wound Contamination on Outcomes of Abdominal Wall Reconstruction Using Acellular Dermal Matrix: 14 Year Experience with More Than 700 Patients
This study of over 700 patients evaluated outcomes of abdominal wall reconstruction using acellular dermal matrix with increasing CDC levels of bacterial contamination. For the first time it was demonstrated that there was an increased risk of surgical site occurrence and infection but not hernia recurrence. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 13, 2021 Category: Surgery Authors: Abbas M. Hassan, Malke Asaad, Allison J. Seitz, Jun Liu, Charles E. Butler Tags: Original Scientific Article Source Type: research

Primary Operation with Systemic Therapy in Patients with de Novo Stage IV Breast Cancer: 10-Year Follow-Up of Protocol MF07-01 Randomized Clinical Trial
The final analysis of the MF07-01 randomized study shows improvement in median overall survival during the 10-year follow-up period for patients who underwent primary breast operation for de novo stage IV breast cancer. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 13, 2021 Category: Surgery Authors: Atilla Soran, Vahit Ozmen, Serdar Ozbas, Hasan Karanlik, Mahmut Muslumanoglu, Abdullah Igci, Nuh Zafer Canturk, Zafer Utkan, Turkkan Evrensel, Efe Sezgin, MF07-01 Study Group Tags: Original Scientific Article Source Type: research

Long-Term Quality of Life after Minimally Invasive vs Open Distal Pancreatectomy in the LEOPARD Randomized Trial
This study found no difference in quality adjusted life years between minimally invasive distal pancreatectomy (MIDP) and open distal pancreatectomy (ODP) after a median of 44 months follow-up (n = 104). Patients in the MIDP group scored higher on cosmetic satisfaction as compared with ODP. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 13, 2021 Category: Surgery Authors: Maarten Korrel, Anne Roelofs, Jony van Hilst, Olivier R. Busch, Freek Daams, Sebastiaan Festen, Bas Groot Koerkamp, Joost Klaase, Misha D. Luyer, Martijn G. van Oijen, Irma M. Verdonck-de Leeuw, Marc G. Besselink, LEOPARD Trial Collaborators Tags: Original Scientific Article Source Type: research

Glucose Tolerance after Pancreatectomy: A Prospective Observational Follow-Up Study of Pancreaticoduodenectomy and Distal Pancreatectomy
We investigated changes in glucose tolerance after pancreatectomy. Glucose tolerance showed a significant trend for improvement after pancreaticoduodenectomy, whereas it worsened after distal pancreatectomy. Insulin secretion decreased after both procedures, although insulin resistance improved after pancreaticoduodenectomy only. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 13, 2021 Category: Surgery Authors: Jun Ishida, Hirochika Toyama, Ippei Matsumoto, Sachiyo Shirakawa, Sachio Terai, Hironori Yamashita, Hiroaki Yanagimoto, Sadaki Asari, Masahiro Kido, Takumi Fukumoto Tags: Original Scientific Article Source Type: research

Reducing Operating Room Cost: Comparing Attending and Surgical Trainee Perception Regarding the Implementation of Supply Receipts
The implementation of operating room supply receipts was well received by faculty and trainees and led to a push for cost-sustainable practices. However, trainees do not yet feel confident discussing these issues. A greater emphasis on cost reduction strategy in curricula and in the practices of our institution is needed. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 13, 2021 Category: Surgery Authors: Bradley S. Kushner, Bruce Hall, Andrew Pierce, Jessica Mody, Rebecca M. Guth, Jackie Martin, Jeffrey A. Blatnik, Shaina R. Eckhouse Tags: Original Scientific Article Source Type: research

Infectious Complication in Relation to the Prophylactic Mesh Position: The PRIMA Trial Revisited
We thank Dr Arora and colleagues for their interest in our recently published article.1 Five questions concerning the classification of primary treatments, mesh overlap, degree of contamination, mesh removal rate, and incidence of organ-confined infections were postulated. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 10, 2021 Category: Surgery Authors: L. Matthijs Van den Dop, Dimitri Sneiders, Gert-Jan Kleinrensink, Hans J. Jeekel, Johan F. Lange, Lucas Timmermans Tags: Letter Source Type: research

View from the Patient Perspective: Mixed-Methods Analysis of Post-Discharge Virtual Visits in a Randomized Controlled Trial
In a randomized-controlled trial evaluating post-discharge virtual visits for surgical patients, virtual visits had greater patient-reported convenience and equal satisfaction compared with in-person visits. Qualitative analysis of patient response revealed that patient experience in both settings was influenced by quality of care, efficiency, and convenience. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - September 9, 2021 Category: Surgery Authors: Kristen Harkey, C Danielle Connor, Huaping Wang, Nicole Kaiser, Brent D. Matthews, Rachel Kelz, Caroline E. Reinke Tags: Original Scientific Article Source Type: research

Infectious Complication in Relation to the Prophylactic Mesh Position: The PRIMA Trial Revisited
We read the article by Van den Dop and colleagues1 with great interest, and appreciate the authors highlighting one of the most important deterrents to prophylactic mesh reinforcement in high-risk patients in routine practice. We came across some observations that might be of interest to the readers. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 31, 2021 Category: Surgery Authors: Abhishek Arora, Manoj Kumar, Manoj Kumar, Ashesh Kumar Jha Tags: Letter Source Type: research

Total Arterial Revascularization: It Is Time for a Dedicated Team
We have read with great interest the article by Velez and colleagues1 focusing on the relevant role of a programmatic focus started at Johns Hopkins Hospital, aiming to increase the use of multiple arterial grafts (MAG) in patients requiring isolated coronary artery bypass grafting (CABG). Despite the encouraging evidence of MAG in coronary patients, and the recommendations reported in the latest guidelines on CABG, the use of MAG, especially the use of radial artery (RA) in addition to bilateral internal thoracic arteries (BITA), is still an underused approach. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 26, 2021 Category: Surgery Authors: Francesco Formica, Francesco Maestri, Francesco Nicolini, Stefano D'Alessandro Tags: Letter Source Type: research

Preceptorship for Surgical Skills: Can It Be Virtual and In-Person?
The field of surgery is ever-changing and requires ongoing learning, skill acquisition, and development. The perspectives shared by the 7 notable surgeons in “Upgrading Your Surgical Skills through Preceptorship”1 highlight a variety of valuable ways, or a toolbox of sorts, to refresh and enhance surgical expertise. To augment these hands-on learning approaches, virtual instruction also should be included in the preceptorship toolkit. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Julie Ann Freischlag Tags: Invited commentary Source Type: research

American College of Surgeons Member Firearm Storage Practices: The Lives We Save May Be Our Own
Gun violence continues to be a tenacious public health problem in need of attention in the US.1 The American College of Surgeons (ACS) has remained fiercely committed to the mitigation of gun violence, in efforts primarily spearheaded by the Committee on Trauma (COT), along with the support of the Board of Regents and the Board of Governors.2,3 Recent initiatives include the initiation of the Improving Social Determinants to Attenuate Violence (ISAVE) task force, aimed at improving social determinants of health as a means of gun violence prevention, development of the Firearm Injury Research Strategy (FIRES) workgroup, aim...
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Stephanie L. Bonne Tags: Invited commentary Source Type: research

Financial Toxicity: Exploring the Role of Treatment Choice
Rapidly increasing healthcare spending has been the focus of both research and policy evaluation for the past 4 decades, with healthcare cost estimated to have increased by 31-fold per capita in the US over this time. This work has largely evaluated the impact of healthcare spending on the national debt, care systems, and payers. More recently, investigators have shifted toward understanding how healthcare cost impacts individuals, covered under the umbrella term, “financial toxicity.” Financial toxicity (FT) describes both objective and subjective measures of financial strain attributable to a healthcare diagn...
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Tasha M. Hughes, Lesly A. Dossett Tags: Invited commentary Source Type: research

The Enhanced-View Totally Extraperitoneal Approach: The True Epitome of Innovation of Modern Abdominal Wall Surgery
This article, by the 2 pioneers of the enhanced-view totally extraperiton eal (eTEP) approach, is an invaluable resource to ensure the safety and efficacy of increasingly frequent extraperitoneal ventral hernia repairs. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Yuri W. Novitsky Tags: Invited commentary Source Type: research

A Simple and Inexpensive Way to Relieve Postoperative Cough-Related Pain
In recent times, perioperative management has generally been based on enhanced recovery after surgery (ERAS) programs.1 ERAS programs include pathways developed based on scientific evidence to promote early recovery of surgical patients. Although advances have been made in surgical critical care through the application of ERAS programs, postoperative pneumonia (POP) remains one of the most serious complications occurring after abdominal operation; the incidence of POP ranges from 1% to 18%, and causes increased morbidity and mortality. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Kazuhiro Hanazaki Tags: Invited commentary Source Type: research

Trauma Informed Care Saves Patients from Physical and Psychological Reinjury
As surgeons, it is all too easy to relegate our services to mere plumbing and carpentry while ignoring the humanity behind the injuries. Truly comprehensive trauma care, however, requires that we understand the environments from which our patients come to us and what they face upon their return. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Leah C. Tatebe Tags: Invited commentary Source Type: research

Contents
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Source Type: research

Editorial Board
(Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Source Type: research

Implementation of a Frailty Assessment and Targeted Care Interventions and Its Association with Reduced Postoperative Complications in Elderly Surgical Patients
In this study, we used a RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to implement an assessment tool to identify frail patients and targeted interventions to improve their outcomes. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Spencer Wilson, Evan Sutherland, Alina Razak, Mollie O ’Brien, Callie Ding, Thien Nguyen, Pam Rosenkranz, Sabrina E. Sanchez Tags: Original scientific article Source Type: research

Timing of Perioperative Pharmacologic Thromboprophylaxis Initiation and its Effect on Venous Thromboembolism and Bleeding Outcomes: A Systematic Review and Meta-Analysis
The objective of this study was to evaluate the association between the start time of perioperative thromboprophylaxis with venous thromboembolism (VTE) and bleeding outcomes. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Kristen McAlpine, Rodney H. Breau, Paulo Werlang, Marc Carrier, Gregoire Le Gal, Dean A. Fergusson, Risa Shorr, Ilias Cagiannos, Christopher Morash, Luke T. Lavall ée Tags: Original scientific article Source Type: research

Timing of Perioperative Pharmacological Thromboprophylaxis Initiation and Its Effect on Venous Thromboembolism and Bleeding Outcomes: A Systematic Review and Meta-Analysis
The objective of this study was to evaluate the association between the start time of peri-operative thromboprophylaxis with venous thromboembolism (VTE) and bleeding outcomes. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Kristen McAlpine, Rodney H. Breau, Paulo Werlang, Marc Carrier, Gregoire Le Gal, Dean A. Fergusson, Risa Shorr, Ilias Cagiannos, Christopher Morash, Luke T. Lavall ée Tags: Original Scientific Article Source Type: research

Understanding Stakeholder Preference for Contralateral Prophylactic Mastectomy: A Conjoint Analysis
To quantify preferences for aspects of contralateral prophylactic mastectomy(CPM) decision-making process among key stakeholders. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Meghana G. Shamsunder, Hina Panchal, Melissa Pilewskie, Clara Lee, Shantanu N. Razdan, Evan Matros Tags: Original Scientific Article Source Type: research

US Medical Licensing Exam Performance and American Board of Surgery Qualifying and Certifying Examinations
This study uses data from application for general surgery residency to predict factors that would predict performance on the American Board of Surgery Qualifying and Certification Examinations. Performance on the US Medical Licensing Examination Step 1 and Step 2 CK predicted passing both the Qualifying and Certifying Examinations. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Steven C. Stain, Jeffrey B. Matthews, Ashar Ata, David B. Adams, Herbert Chen, John R. Potts Tags: Original Scientific Article Source Type: research

Women in Surgery Italia: National Survey Assessing Gender-Related Challenges
In 2019, women accounted for 46% of surgical residents. Despite the international debate on gender disparities, no literature regarding the experience in Italy is available. The aim of this survey study was to assess satisfaction among female surgeons in Italy, and whether they encounter gender-based discrimination. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Sara Parini, Daniela Lucidi, Danila Azzolina, Daunia Verdi, Isabella Frigerio, Andrew A. Gumbs, Gaya Spolverato Tags: Original Scientific Article Source Type: research

Crisis Containment: Tools for Harm Mitigation in Surgery
Surgical crises represent unrecognised opportunities for improving patient safety and value in healthcare. The first step in a crisis response is to contain and mitigate harm. Whilst the principles of damage control are well established in surgery, methods of containing harm on broader clinical and organizational levels are not clearly defined. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Petrut Gogalniceanu, Nicos Kessaris, Nikolaos Karydis, Ioannis Loukopoulos, Nick Sevdalis, Nizam Mamode Tags: Original Scientific Article Source Type: research

Implementation of a Frailty Assessment and Targeted Care Interventions and Association with Reduced Postoperative Complications in Elderly Surgical Patients
A reach, effectiveness, adoption, implementation, and maintenance framework implementation resulted in most elderly surgical patients being screened with a frailty assessment and receiving targeted frailty intervention. Despite challenges with assessment uptake and nursing intervention, implementation was associated with a decrease in complication. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 23, 2021 Category: Surgery Authors: Spencer Wilson, Evan Sutherland, Alina Razak, Mollie O ’Brien, Callie Ding, Thien Nguyen, Pam Rosenkranz, Sabrina E. Sanchez Tags: Original Scientific Article Source Type: research

Multi-Arterial Grafting in Coronary Artery Bypass Grafting: Playing the Long Game
We would like to thank Dr Formica and colleagues for their kind comments regarding our submission on measures to improve multi-arterial grafting (MAG) for coronary artery bypass grafting (CABG).1 We agree that despite evidence, MAG is an underused approach and there are several barriers to the adoption of MAG. Some of these barriers include the increased technical complexity of the procedure, extended operative time, and surgeon preference. We hope that this contribution demonstrates that MAG use can be widely adopted, and provides encouragement and education toward that goal. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 17, 2021 Category: Surgery Authors: Ana K. Velez, Jennifer S. Lawton Tags: Letter Source Type: research

Reflections on Surgical Practice: Lessons Learned along the Way and Notes to My Young Colleagues
I still remember the last time I walked out the front door of Emory Hospital to begin my surgical journey. As I somewhat triumphantly moved across the large front lawn, the essence and significance of this step was brought starkly home to me as I thought back to an exchange that I once had with a staff anesthesiologist. We had just finished a bilateral lower extremity amputation necessitated by complications from a recent aortic bypass. As I walked out of the operating room, with some degree of self-validation, I said, “Well, sir, you cannot say we did not give it the good old college try.” He looked at me with...
Source: Journal of the American College of Surgeons - August 14, 2021 Category: Surgery Authors: James K. Elsey Tags: Special Article Source Type: research

The Story of Blood for Shock Resuscitation: How the Pendulum Swings
Whole blood transfusion (WBT) began in 1667 as a treatment for mental illness with predictably poor results. Its therapeutic utility and widespread use were initially limited by deficiencies in transfusion science and antisepsis. James Blundell, a British obstetrician, was recognized for the first allotransfusion in 1825. However, WBT did not become safe and therapeutic until the early 20th century with the advent of reliable equipment, sterilization and blood typing. The discovery of citrate preservation in World War I allowed a separation of donor from recipient and introduced the practice of blood banking. (Source: Jour...
Source: Journal of the American College of Surgeons - August 11, 2021 Category: Surgery Authors: Samuel P. Carmichael, Nicholas Lin, Meagan E. Evangelista, John B. Holcomb Tags: History Source Type: research

Publication Inaccuracies Listed in General Surgery Residency Training Program Applications
A significant proportion of general surgery applicants had serious inaccuracies regarding peer-reviewed publications on their electronic residency application service application, which may represent inattention to detail or intentional unprofessional behavior. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 9, 2021 Category: Surgery Authors: Daniel Dante Yeh, John M. Reynolds, Gerd Daniel Pust, Danny Sleeman, Jonathan P. Meizoso, Christopher Menzel, Davis Horkan, Matthew Lineberry, Rachel Yudkowsky, Yoon Soo Park Tags: Original Scientific Article Source Type: research

Imposter Syndrome in Surgical Trainees: Clance Imposter Phenomenon Scale Assessment in General Surgery Residents
Imposter syndrome occurs when high-achieving individuals have a pervasive sense of self-doubt combined with fear of being exposed as a fraud despite objective measures of success. This threatens mental health and well-being. The prevalence and severity of imposter syndrome has not been studied amongst general surgery residents on a large scale. The primary outcome of this study was the prevalence and severity of imposter syndrome. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - August 9, 2021 Category: Surgery Authors: Anuradha R. Bhama, Ethan M. Ritz, Rahul J. Anand, Edward D. Auyang, Jeremy Lipman, Jacob A. Greenberg, Muneera R. Kapadia Tags: Original Scientific Article Source Type: research

Strategies for Trauma Centers to Address the Root Causes of Violence: Recommendations from the Improving Social Determinants to Attenuate Violence (ISAVE) Workgroup of the American College of Surgeons Committee on Trauma
In 1985, Surgeon General C Everett Koop held the “Workshop on Violence and Public Health.”1 His initial remarks to the attendants included the following: “Our focus will be squarely on how the health professions might provide better care for victims of violence and also how they might contribute to the prevention of violence.” He went on t o say, “It is clear that medicine, nursing, psychology, and social service professions have been slow in developing a response to violence that is integral to their daily professional life.”1 Dr Koop speculated that health professions can make a big im...
Source: Journal of the American College of Surgeons - July 30, 2021 Category: Surgery Authors: Rochelle A. Dicker, Arielle Thomas, Eileen M. Bulger, Ronald M. Stewart, Stephanie Bonne, Tracey A. Dechert, Randi Smith, Altovise Love-Craighead, Fatimah Dreier, Meera Kotagal, Tamara Kozyckyj, Holly Michaels, ISAVE Workgroup, Members of the ISAVE Workgr Tags: Ethics Source Type: research

Intraoperative Time-Out to Promote the Implementation of the Critical View of Safety in Laparoscopic Cholecystectomy: A Video-Based Assessment of 343 Procedures
Achieving a critical view of safety in laparoscopic cholecystectomy is recommended but inconsistently performed. This before-and-after study assessed 343 procedural videos and found that performing a short intraoperative time-out drastically increased the implementation of this recommended step for safe cholecystectomy. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - July 26, 2021 Category: Surgery Authors: Pietro Mascagni, Mar ía Rita Rodríguez-Luna, Takeshi Urade, Emanuele Felli, Patrick Pessaux, Didier Mutter, Jacques Marescaux, Guido Costamagna, Bernard Dallemagne, Nicolas Padoy Tags: Original Scientific Article Source Type: research

Importance of Practice Continuity
The recent literature is replete with articles on the exodus of physicians from medical practice in a variety of specialties and particularly on the impact of burnout 1,2,3, which may be manifested in a number of forms. One consequence of fatigue or burnout may be the early exit from practice.(4) In 2011, a paper(5) was published on reasons for leaving their current practice. These reasons included the ability to pursue a different practice as a surgeon, the assumption of administrative duties, pursuit of a non-surgical career, as well as traditional retirement. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - July 26, 2021 Category: Surgery Authors: J David Richardson, Ajit K. Sachdeva, David B. Hoyt Tags: Surgical Perspective Source Type: research

Impact of Early Cholecystectomy on the Cost of Treating Mild Gallstone Pancreatitis: Gallstone PANC Trial
This was a secondary evaluation of the Gallstone PANC Trial, which showed that early cholecystectomy compared with after clinical resolution for mild gallstone pancreatitis reduced 30-day hospital length of stay without increasing major postoperative complication. Bayesian cost analysis demonstrated early cholecystectomy has an 81% posterior probability of reducing 90-day total cost. (Source: Journal of the American College of Surgeons)
Source: Journal of the American College of Surgeons - July 26, 2021 Category: Surgery Authors: Kayla D. Isbell, Shuyan Wei, Shah-Jahan M. Dodwad, Elenir BC. Avritscher, Krislynn M. Mueck, Karla Bernardi, Gabrielle E. Hatton, Mike K. Liang, Tien C. Ko, Lillian S. Kao Tags: Original Scientific Article Source Type: research