Journal of the American College of Surgeons
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Multicenter Study
Robotic Approach to Outpatient Inguinal Hernia Repair.
Robotics offers improved ergonomics, visualization, instrument articulation, and tremor filtration. Disadvantages include startup cost and system breakdown. Surgeon education notwithstanding, we hypothesize that robotic inguinal hernia repair carries minimal advantages over the laparoscopic or open approach. ⋯ Robotic surgery has increased charges and is performed in sicker, higher-income patients. The open approach is more apt to be performed in black/Hispanic, self-pay patients, and for-profit hospitals. The role for robotic inguinal hernia repair is undefined.
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Multicenter Study
Underrepresented Minorities in General Surgery Residency: Analysis of Interviewed Applicants, Residents, and Core Teaching Faculty.
The Accreditation Council for Graduate Medical Education (ACGME) requires diversity in residency. The self-identified race/ethnicities of general surgery applicants, residents, and core teaching faculty were assessed to evaluate underrepresented minority (URM) representation in surgery residency programs and to determine the impact of URM faculty and residents on URM applicants' selection for interview or match. ⋯ Programs with a greater proportion of URM core faculty or residents did not select a greater proportion of URM applicants for interview. However, core faculty and resident racial diversity were correlated. Recruitment of racially/ethnically diverse trainees and faculty will require ongoing analysis to develop effective recruitment strategies.
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Multicenter Study
Correlation of Proposed Surgical Volume Standards for Complex Cancer Surgery with Hospital Mortality.
Minimum case volume thresholds for complex cancer operations have been proposed by the Leapfrog Group. There has been no formal study of how these standards correlate with actual hospital mortality. ⋯ Although proposed minimum VTs are reasonably good at identifying PPHs, they misclassify 3 of 4 hospitals below the minimum VT as PPHs and 1 of 4 PPHs as meeting the minimum VT. Use of case volume cutoffs alone does not correlate well with actual hospital mortality.