Journal of the American College of Surgeons
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Randomized Controlled Trial Clinical Trial
Assessment of basic endoscopic performance using a virtual reality simulator.
The objective of this study was to evaluate the effect of supervised training using a state-of-the-art virtual reality (VR) genitourinary endoscopy simulator on the basic endoscopic skills of novice endoscopists. ⋯ Students trained on the VR simulator demonstrated statistically significant improvement on repeat testing, but the control group showed no improvement. Endourologic training using VR simulation facilitates performance of basic endourologic tasks and might translate into better performance in the operating room.
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Comparative Study
Split liver transplantation and risk to the adult recipient: analysis using matched pairs.
The technique of liver splitting is an effective way of increasing the donor pool and reducing pediatric waiting list mortality. But the procedure is still not fully accepted because of concerns that it may cause complications in adult recipients. ⋯ SLT, using the extended right hepatic lobe, does not notably differ from WLT with regard to initial graft function, postoperative complications, or patient and graft survival. Based on this, the liver can be considered a paired organ, and mandatory splitting of good-quality livers can be recommended.
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Early diagnosis of familial medullary thyroid carcinoma (MTC) is currently done by genetic analysis. These techniques have replaced calcitonin stimulation testing, which was previously used for this purpose. Some studies suggest a relationship between MTC spread and calcitonin levels. The aim of this study was to assess whether the tumor burden of MTC associated with multiple endocrine neoplasia type 2A (MEN 2A) syndrome can be estimated from the plasma calcitonin values before surgery. ⋯ Preoperative calcitonin testing may be useful for assessing tumor spread and should be considered when deciding the extent of surgery for MEN 2A MTC.