The American surgeon
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The American surgeon · Mar 2007
Case ReportsRemoval of a large spherical foreign object from the rectum using an obstetric vacuum device: a case report.
Reports of retained rectal foreign bodies are increasingly common worldwide. It is likely that any surgeon practicing at a major medical center will encounter this type of case, and thus, should be familiar with both surgical and nonsurgical management options. ⋯ Low-lying objects can usually be extracted in the emergency room transanally, whereas high-lying foreign bodies may require anesthesia and laparotomy. We report an experience using an obstetric vacuum device to extract a high-lying foreign body from the rectum.
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The American surgeon · Mar 2007
Case ReportsAsymptomatic intussusception of the appendix secondary to endometriosis.
This is a report of a 47-year-old woman with an asymptomatic clinical presentation of appendiceal intussusception secondary to endometriosis. Initially discovered during routine colonoscopy as a submucosal mass, it was ultimately diagnosed after surgical resection by pathology findings. The theories regarding the pathogenesis of appendiceal intussusception are reviewed and discussed here.
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Maintenance of Certification (MOC) is the most recent stage in the evolution of specialty board certification. Driven by increasing concerns over the quality and safety of medical care, MOC represents a change in the frequency and the nature of the requirements of existing recertification. ⋯ The focus of these assessments is for improvement rather than judgment. The extent to which MOC succeeds will reflect surgeons' ability to improve the quality of care through voluntary efforts.
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The American surgeon · Feb 2007
A young surgeon's perspective on alternate surgical training pathways.
Most residents in training today are in focused on their training, and the thoughts of changing the structure of residencies and fellowships is something that they are ambivalent about or have never heard anything about. The small minority who are vocal on these issues represent an activist group supporting change. This group is very vocal and raises many of the excellent questions we have examined. ⋯ A wholesale rewrite of surgical training in the United States would likely not be well received. However, the addition of alternate pathways, on a limited scale and under close scrutiny and supervision, could evaluate interest and ease into this type of program. Before embarking on massive changes in surgical training, scientific, statistically valid research determining the interest of residents in these types of programs will target changes to make these programs successful.