Surgical innovation
-
Surgical innovation · Aug 2019
Association Between Perioperative Fluid Balance and 30-Day Unplanned Readmission After Major Abdominal Surgery.
Perioperative positive fluid balance (FB) increases postoperative complication and length of hospital stay. We aimed to investigate 30-day unplanned readmission after major abdominal surgery based on perioperative FB (%) on postoperative days (POD) 0 to 3. This retrospective cohort study analyzed medical records of patients who underwent elective major abdominal surgery (surgery time >2 hours, estimated blood loss >500 mL) at a single tertiary academic hospital from January 2010 to December 2017. ⋯ However, an increase of 10 000 points in the total relative value unit scores was associated with 5% increase in 30-day unplanned readmission (odds ratio = 1.05, 95% confidence interval = 1.02-1.07; P = .001), and 1-hour increase in surgery time was associated with 10% increase in 30-day unplanned readmission (odds ratio = 1.10, 95% confidence interval = 1.05-1.15; P < .001). This study showed that perioperative FB is not associated with 30-day unplanned readmission rate after a major abdominal surgery. Total relative value unit scores and duration of surgery were significantly associated with 30-day unplanned readmission rate after major abdominal surgery in a single tertiary academic hospital.
-
Surgical innovation · Jun 2019
A Virtual Reality Environment to Visualize Three-Dimensional Patient-Specific Models by a Mobile Head-Mounted Display.
With the availability of low-cost head-mounted displays (HMDs), virtual reality environments (VREs) are increasingly being used in medicine for teaching and clinical purposes. Our aim was to develop an interactive, user-friendly VRE for tridimensional visualization of patient-specific organs, establishing a workflow to transfer 3-dimensional (3D) models from imaging datasets to our immersive VRE. ⋯ Our approach, based on open-source software and mobile hardware, proved to be a valid and well-appreciated system to visualize 3D patient-specific models, paving the way for a potential new tool for teaching and preoperative planning.
-
Surgical innovation · Jun 2018
Development of a Model for the Acquisition and Assessment of Advanced Laparoscopic Suturing Skills Using an Automated Device.
Needs assessment identified a gap regarding laparoscopic suturing skills targeted in simulation. This study collected validity evidence for an advanced laparoscopic suturing task using an Endo StitchTM device. ⋯ This study provides validity evidence for the task as a measure of laparoscopic suturing skill using an automated suturing device. It could help trainees acquire the skills they need to better prepare for clinical learning.
-
Surgical innovation · Feb 2018
Coaching Experts: Applications to Surgeons and Continuing Professional Development.
Surgery is a science and an art, which is mastered through years of training and refined by the accumulation of individual experience and preference. Continuing professional development (CPD) is a concept that emphasizes a self-directed approach to education. Coaching is a process that leads to increased utilization of a person's current skills and resources without counselling or advising. ⋯ Coaching of surgeons is a conceptually formidable tool in the successful implementation of effective CPD programs. CPD currently provides an opportunity for surgeons to gain access to constantly evolving medical knowledge and technique; however, there is no accountability to its understanding or implementation. Coaches have the potential to provide confidential appraisal and feedback in a constructive approach with the aim to eliminate any barriers to the transfer of technique and knowledge.