International journal of surgery
-
Comparative Study
Robot-assisted laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy--a comparative study.
Traditionally, pancreatic surgery is considered as one of the most complex surgeries. The recently developed robotic technology allows surgeons to perform pancreaticoduodenectomy. A comparative study was undertaken to study outcomes between robotic approach and open approach. ⋯ This study showed that robot-assisted laparoscopic pancreaticoduodenectomy was safe and feasible in appropriately selected patients. However, it is too early to draw definitive conclusions about the value of robot-assisted laparoscopic pancreaticoduodenectomy. In light of remaining uncertainties regarding short-term and long-term outcome, caution should be exercised in the assessment of the appropriateness of this operation for individual patient.
-
Clinical handover (handoff, sign out) is frequently implicated as a cause of adverse events in hospitalised patients. Complex social interactions such as handover are subject to the teamwork skills of the participants and there is increasing evidence that the quality of teamwork in handover affects outcome. Teamwork skills have been assessed in one-to-one handovers but the applicability of these measurement tools to healthcare team shift handovers remains unproven. This study aimed to assess the feasibility of measurement of teamwork skills in shift handover and the applicability of adapted teamwork skills rating scales to a shift handover environment. ⋯ Teamwork skills vary widely between handovers and can be consistently scored using both rating scales. It is feasible to use adapted teamwork skill rating scales in shift handover and they appear to measure different constructs to traditional handover measures such as interruptions and communication checklist completion. The assessment of teamwork skills is a necessary complement to the assessment of completeness of information transfer when evaluating the overall quality of handover.
-
Pediatric injuries pose a significant health burden in sub-Saharan Africa, though historic data are too scarce to appreciate the extent of the problem. The purpose of this study is to utilize a comprehensive database to describe the epidemiology of pediatric injuries at a tertiary hospital in Malawi. ⋯ This study revealed patterns of injury based upon age, gender, location, and season. Our results may prove useful to stakeholders in injury prevention for designing, evaluating, and implementing programs to improve public safety in children in Malawi and similar resource poor nations.
-
Recent studies show a significant rate of adverse events in hospitalized patients in developing/transitional countries--with approximately 18% of them related to surgical procedures. Understanding and preventing these errors requires adequate training in patient safety research methods--however, relevant training programs are currently lacking. We developed, delivered and evaluated a training program to address this gap. ⋯ We have developed a viable, WHO-driven training program that can be delivered to clinical and non-clinical researchers to develop their competencies and thereby build capacity in developing/transitional countries to carry out surgical safety research. All program materials are available in English and Spanish for research, training and dissemination.
-
Attracting the best medical graduates to trauma-related specialties is pivotal for excellent injury management in future, especially with the rising global incidence of injuries. We sought to explore the interest of Nigerian medical students and interns in Orthopaedics, Cardiothoracic, Neurological, Burns and Plastic and General Surgery specialties. ⋯ Interest of medical students and interns in trauma-related specialties may be sustained and enhanced by practicing surgeons through mentoring and by serving as role models. Training programs in surgery should be revisited and made less stressful while lifestyle issues need to be made more favourable.