Robot Rebuked
Once again, a paper has come out evaluating the efficacy and cost effectiveness of daVinci Robotic surgery. FromDiseases of the Colon& Rectum comes a retrospective review assessing elective robotic vs laparoscopic colectomy from 2008-2009 (over 12,000 procedures):Patients undergoing robotic and laparoscopic procedures experienced similar rates of intraoperative (3.0% vs 3.3%; adjusted OR = 0.88 (0.35 –2.22)) and postoperative (21.7% vs 21.6%; adjusted OR = 0.84 (0.54–1.30)) complications, as well as risk-adjusted average lengths of stay (5.4 vs 5.5 days, p = 0.66). However,robotic-assisted colectomy resulted ...
Source: Buckeye Surgeon - March 19, 2013 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
Mental Practice Makes Perfect
Surgeons do it. Tennis players do it. But do the rest of us undervalue the mental rehearsal of challenging activities?
If you were to undergo brain surgery, would you care if the surgeon regularly carried out mental practice of the operation? Or, would you only be interested in the physical practice?
(By mental practice I don't mean getting 'psyched up' or making plans or getting in the right frame of mind; I mean mentally running through the physical movements required for the operation.)
Quite naturally you'd probably be much more interested in how often the surgeon had carried out the operation in real life, rather than...
Source: PsyBlog | Psychology Blog - March 5, 2013 Category: Psychiatrists and Psychologists Authors: Jeremy Dean Tags: Uncategorized Source Type: blogs
Study Questions Cost Savings of Weight-Loss Surgery
This study indicates that bariatric surgery does not reduce overall healthcare costs in the long term.
In addition, there is no evidence that any one type of surgery is more likely to reduce long-term healthcare costs — those undergoing laparoscopic surgery had lower costs in the first few years after surgery, but these differences did not persist.
Bariatric surgery did not reduce healthcare costs over the long term when surgery patients were compared with matched obese patients who did not have surgery, a review of almost 30,000 cases showed. Comment: as for other studies that have had high profile press releases t...
Source: Dr. Buttery's Public Health BLOG - February 22, 2013 Category: Epidemiologists Authors: cbuttery Tags: Chronic Disease Economics policy Prevention research Source Type: blogs
Robotic Hysterectomy: Everybody's Doing It!
A cohort study done by Columbia University evaluating the rise of robotic hysterectomy from 2007-2010 had some pretty breathtaking findings.
Use of robotically assisted hysterectomy increased from 0.5% in 2007 to 9.5% of all hysterectomies in 2010. During the same time period, laparoscopic hysterectomy rates increased from 24.3% to 30.5%. Three years after the first robotic procedure at hospitals where robotically assisted hysterectomy was performed, robotically assisted hysterectomy accounted for 22.4% of all hysterectomies.... In a propensity score–matched analysis, the overall complication rates were simi...
Source: Buckeye Surgeon - February 22, 2013 Category: Surgeons Authors: Jeffrey Parks MD Source Type: blogs
Robotic Hysterectomy: Everybody's Doing It!
Acohort study done by Columbia University evaluating the rise of robotic hysterectomy from 2007-2010 had some pretty breathtaking findings.Use ofrobotically assisted hysterectomy increased from 0.5% in 2007 to 9.5% of all hysterectomies in 2010. During the same time period, laparoscopic hysterectomy rates increased from 24.3% to 30.5%. Three years after the first robotic procedure at hospitals where robotically assisted hysterectomy was performed, robotically assisted hysterectomy accounted for 22.4% of all hysterectomies.... In a propensity score –matched analysis, theoverall complication rates were similar fo...
Source: Buckeye Surgeon - February 21, 2013 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
Top stories in health and medicine, February 20, 2013
This series is brought to you by MedPage Today.1. Deaths Trigger DEA Investigation of Pain Specialist. Among clinicians seeking ways to safely treat chronic pain, Lynn Webster, MD, serves as a beacon — a leading expert in the use of narcotic painkillers, who created an assessment tool to identify patients who are most likely to abuse opioids.2. Psych Meds Often On Board in Opioid Overdoses. When patients overdose on prescription opioid painkillers, other drugs given for mental health disorders are often involved.3. Use of Robots for Hysterectomy Soars, but with Little Benefit. Robotically assisted hysterectomy increa...
Source: Kevin, M.D. - Medical Weblog - February 20, 2013 Category: Family Physicians Tags: News OB/GYN Psychiatry Source Type: blogs
Leaks
This study is a retrospective review of over 70,000 low anterior resections, nationwide, from the years 2006-2009.
Results The AL rate was 13.68%. The AL group had higher mortality vs the non-AL group (1.78% vs 0.74%). Hospital length of stay and cost were significantly higher in the AL group. Laparoscopic and open resections with a diverting stoma had a higher incidence of AL than those without a stoma (15.97% vs 13.25%). Multivariate analysis revealed that weight loss and malnutrition, fluid and electrolyte disorders, male sex, and stoma placement were associated with a higher risk of AL. The us...
Source: Buckeye Surgeon - February 20, 2013 Category: Surgeons Authors: Jeffrey Parks MD Source Type: blogs
Leaks
This study is a retrospective review of over 70,000 low anterior resections, nationwide, from the years 2006-2009. Results The AL rate was 13.68%. The AL group had higher mortality vs the non-AL group (1.78% vs 0.74%). Hospital length of stay and cost were significantly higher in the AL group. Laparoscopic and open resections with a diverting stoma had a higher incidence of AL than those without a stoma (15.97% vs 13.25%). Multivariate analysis revealed that weight loss and malnutrition, fluid and electrolyte disorders, male sex, and stoma placement were associated with a higher risk of AL. The use of laparos...
Source: Buckeye Surgeon - February 19, 2013 Category: Surgery Authors: Jeffrey Parks MD FACS Source Type: blogs
CareFusion Unveils Snowden-Pencer Take-Apart Laparoscopic Scissors
CareFusion has released its new Snowden-Pencer take-apart laparoscopic scissors. The modular devices were created for easy disassembly and the handles are compatible with other Snowden-Pencer take-apart laparoscopic instruments like dissectors and clamps.The single-use scissors come with their own insulated shaft to reduce how much cleaning needs to be done.Read More (Source: Medgadget)
Source: Medgadget - February 15, 2013 Category: Technology Consultants Authors: Gene Ostrovsky Tags: Surgery Source Type: blogs
Dash 22
The consult came in around 3:30 on a Friday. The surgeon wasn't on call but his partner was tied up and he, the surgeon, felt obligated to see the new patient before it got too late. To do otherwise is known as a "dick move" in the world of small private surgical practice. The computer record outlined the picture of a man in his late seventies with an unremarkable medical history. He only took something for gout and various other over the counter vitamins. He took something called Life-X 3000. The consult request was "evaluate for gallbladder disease". The patient had been adm...
Source: Buckeye Surgeon - February 10, 2013 Category: Surgeons Authors: Jeffrey Parks MD Source Type: blogs
A Universal Translator for Medicine
Steven Schwaitzberg, Chief of Surgery at the Cambridge Health Alliance at the Harvard Medical School Teaching Hospital, has been preparing surgeons for the real world for years. Recently he’s developed interest in teaching laparoscopic surgery to distant students using video teleconferencing, but in that process the language gap has turned out to be rather wide. To overcome, a team came together to develop a real-time universal translator which Dr Schwaitzberg presented at TEDxBeaconStreet: Read More (Source: Medgadget)
Source: Medgadget - February 5, 2013 Category: Technology Consultants Authors: Gene Ostrovsky Tags: etc. Surgery Telemedicine Source Type: blogs
A universal translator for surgeons?
Steven Schwaitzberg had a great TED talk about developing a technology which combines video conferencing and a real-time universal translator while teaching laparoscopic surgery. (Source: ScienceRoll)
Source: ScienceRoll - February 5, 2013 Category: Geneticists and Genetics Commentators Authors: Dr. Bertalan Meskó Tags: Surgery Ted Talks Video Source Type: blogs
Single Port Appy?
Conclusions: SPLA failed to show any advantages over CLA relative to
pain and cosmesis. However, SPLA is as safe as CLA (Source: Buckeye Surgeon)
Source: Buckeye Surgeon - February 3, 2013 Category: Surgeons Authors: Jeffrey Parks MD Source Type: blogs
Does IVF cause premature menopause ?
Many women worry that going through IVF will deplete their ovarian reserve , as a result of which they will run out of eggs , reduce their long-term fertility, and reach the menopause earlier. Logically, this makes sense ! We all know that women are born with a certain number of eggs ; and that their ovaries do not produce any new eggs after birth. If the doctor stimulates the ovaries to grow lots of eggs during the IVF treatment by giving hormonal injections, won’t this mean that there’ll be fewer eggs left in the ovaries after the IVF treatment – especially if they are doing many IVF cycles ? When going throu...
Source: The Patient's Doctor - January 31, 2013 Category: Obstetricians and Gynecologists Tags: Health In vitro fertilisation ivf Follicle-stimulating hormone FSH Menstrual cycle Infertility Menopause Source Type: blogs
All you wanted to know about embryo transfer
The
day when our in-vitro embryos return back to us (to their mama !) is
one of the most exciting moments of an IVF cycle. We forget the
struggles we went through when we are admiring our microscopic babies
under the microscope. Embryo transfer is one of the rate-limiting steps
in an IVF cycle and plays a pivotal role in determining IVF success.
Since the invention of IVF, major developments have been made in ovarian
stimulation protocols; the way oocytes are collected ; and in the IVF
lab; but the
embryo transfer method remains largely unchanged. Embryo transfer done
badly by an
inexperienced doctor can change th...
Source: The Patient's Doctor - January 28, 2013 Category: Obstetricians and Gynecologists Tags: Health In vitro fertilisation India Uterus ivf Embryo transfer Infertility Source Type: blogs
