Surgical innovation
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Surgical innovation · Jun 2005
Remote presence proctoring by using a wireless remote-control videoconferencing system.
Remote presence in an operating room to allow an experienced surgeon to proctor a surgeon has been promised through robotics and telesurgery solutions. Although several such systems have been developed and commercialized, little progress has been made using telesurgery for anything more than live demonstrations of surgery. This pilot project explored the use of a new videoconferencing capability to determine if it offers advantages over existing systems. ⋯ The ability to move the device within the environment rather than just observe the environment from multiple fixed camera angles gave the surgeon a similar feel of true presence. A remote-controlled videoconferencing system provides a more real experience for both student and proctor. Future development of such a device could greatly facilitate progress in implementation of remote presence proctoring.
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Surgical innovation · Jun 2005
Evaluation of the efficacy of the electrosurgical bipolar vessel sealer (LigaSure) devices in sealing lymphatic vessels.
Various sources of ultrasonic and thermal energy have been developed to facilitate blood vessel ligation. However, their efficacy in sealing lymphatics has not been clearly established to date. We hypothesized that the electrosurgical bipolar vessel sealer (EBVS) produces reliable and durable sealing of large lymphatic vessels in a porcine model. ⋯ We demonstrated that the use of EBVS results in a fast and effective sealing of large porcine lymphatic vessels. The seals created by all 3 devices burst at markedly supraphysiologic intraluminal pressures. Ongoing randomized human trials may prove the clinical benefits of the routine use of EBVS devices for various tissue dissections.
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Surgical innovation · Mar 2005
ReviewEvidence-based practice in laparoscopic surgery: perioperative care.
Best practices for reducing risks of postoperative infection, venous thromboembolism, and nausea and vomiting in patients undergoing laparoscopic surgery are uncertain. As a result, perioperative care varies widely. We reviewed evidence from randomized clinical trials on the effectiveness of interventions for postoperative infection, venous thromboembolism, and nausea and vomiting Data sources were the Cochrane Central Register of Clinical Trials, reference lists of published trials, and randomized clinical trials published in English since 1990. ⋯ Routine antibiotic use in laparoscopic cholecystectomy, and possibly other clean procedures not involving placement of prostheses, is likely unnecessary. Similarly, venous thromboembolism prophylaxis is probably unnecessary for low-risk patients undergoing brief procedures. Of a wide variety of methods for reducing postoperative nausea and vomiting, serotonin receptor antagonists appear the most effective and should be considered for routine prophylaxis.
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Surgical innovation · Dec 2004
Comparative StudyMinimally invasive surgeons of Texas: a new concept in fellowship training.
Minimally invasive fellowship training has seen phenomenal growth, with 94 organized fellowship programs in North America. Training experience is varied across programs owing to the differences in surgical practices. Many programs are often weighted to a specific field of advanced laparoscopic surgery, which can limit a fellow's clinical experience. Minimally Invasive Surgeons of Texas (MIST) is a combined organization of four independent private practice and academic MIS fellowships brought together for the common goal of improved fellowship training.
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Surgical innovation · Dec 2004
Editorial Comparative StudySurgical leadership in the business of surgery.