The British journal of surgery
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Randomized Controlled Trial Comparative Study
Randomized clinical trial of dexamethasone versus placebo in laparoscopic inguinal hernia repair.
The effect of dexamethasone on recovery and length of convalescence has not been evaluated in patients after laparoscopic groin hernia repair. It was hypothesized that preoperative intravenous dexamethasone would reduce postoperative pain. ⋯ A single preoperative dose of 8 mg dexamethasone before laparoscopic groin hernia repair had no clinical effect on early postoperative pain, discomfort or fatigue after TAPP inguinal hernia repair, but resulted in a significantly lower use of antiemetics in the PACU.
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The application of digital games for training medical professionals is on the rise. So-called 'serious' games form training tools that provide a challenging simulated environment, ideal for future surgical training. Ultimately, serious games are directed at reducing medical error and subsequent healthcare costs. The aim was to review current serious games for training medical professionals and to evaluate the validity testing of such games. ⋯ Blended and interactive learning by means of serious games may be applied to train both technical and non-technical skills relevant to the surgical field. Games developed or used for this purpose need validation before integration into surgical teaching curricula.
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Methylene blue is an intraoperative adjunct for localization of enlarged parathyroid glands. The availability of preoperative and other intraoperative localization methods, and the reported adverse effects of methylene blue make its routine use debatable. The aim of this study was to perform a systematic review of the use of methylene blue in parathyroidectomy. ⋯ Observational evidence suggests that methylene blue is efficacious in identifying enlarged parathyroid glands. Toxicity appears to be mild in the absence of concomitant use of serotonin reuptake inhibitors. The effectiveness of methylene blue in the context of currently used preoperative and intraoperative localization techniques has yet to be shown.
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Patients with frequent and life-threatening attacks of cholangitis due to bilateral primary hepatolithiasis with atrophy of the main liver and giant hypertrophy of the caudate lobe were assessed for caudate lobe-sparing subtotal hepatectomy. ⋯ In selected patients with bilateral primary hepatolithiasis, caudate lobe-sparing subtotal hepatectomy is a safe and effective treatment.