Surgical Telementoring Initiation of a Regional Telemedicine Network: Projection of Surgical Expertise in the WWAMI Region

Author(s):  
Yoon Sang Kim
Keyword(s):  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Paweł Bąkowski ◽  
Kamilla Bąkowska-Żywicka ◽  
Tomasz Piontek

Abstract Background Meniscus repair is a challenging task in knee arthroscopy. Currently, there are a variety of arthroscopic methods available for meniscus repair. The purpose of this study was to determine a consensus in meniscus tear treatment in the environment of Polish orthopaedists. Methods A total of 205 registered orthopaedic surgeons participated in the surveys. The survey consisted of 35 questions regarding general arthroscopy and postoperative management, including physicians’ level of expertise, anaesthesia, postoperative treatment, rehabilitation and procedures performed. Comparisons were made between knee arthroscopy experts (> 100 arthroscopies performed per year) and non-experts (≤ 100 cases) on aspects of patient care. Results The most important finding of this study was the agreement among almost all aspects of the knee arthroscopy approach. Consensus among Polish surgeons was noticed in choosing regional anaesthesia for knee arthroscopy, the lack of need for knee braces and knee medications, the of use of LMW heparin for thromboprophylaxis, 1–2 days of hospitalization, the recommendation of rehabilitation and the use of magnetic resonance as a diagnostic test for meniscus damage. Surgical expertise was significantly associated with the performance of meniscus suture procedures (p = 0.009). Experts recommended starting rehabilitation on the day of surgery (p = 0.007) and were more likely to use objective physical tests (p = 0.003). Non-expert surgeons recommended a longer period from meniscus suture to full-range knee motion (p = 0.001) and admitted that patient age does matter for meniscus repair qualification (p = 0.002). Conclusions There is consensus among almost all issues of meniscus tear treatment in the environment of Polish orthopaedists; however, the issues of rehabilitation and the use of advanced meniscus repair techniques are associated with surgical expertise.


2016 ◽  
Vol 174 (1) ◽  
pp. D1-D8 ◽  
Author(s):  
Salvatore Minisola ◽  
Cristiana Cipriani ◽  
Daniele Diacinti ◽  
Francesco Tartaglia ◽  
Alfredo Scillitani ◽  
...  

Primary hyperparathyroidism (PHPT) is one of the most frequent endocrine diseases worldwide. Surgery is the only potentially curable option for patients with this disorder, even though in asymptomatic patients 50 years of age or older without end organ complications, a conservative treatment may be a possible alternative. Bilateral neck exploration under general anaesthesia has been the standard for the definitive treatment. However, significant improvements in preoperative imaging, together with the implementation of rapid parathyroid hormone determination, have determined an increased implementation of focused, minimally invasive surgical approach. Surgeons prefer to have a localization study before an operation (both in the classical scenario and in the minimally invasive procedure). They are not satisfied by having been referred a patient with just a biochemical diagnosis of PHPT. Imaging studies must not be utilized to make the diagnosis of PHPT. They should be obtained to both assist in determining disease etiology and to guide operative procedures together with the nuclear medicine doctor and, most importantly, with the surgeon. On the contrary, apart from minimally invasive procedures in which localization procedures are an obligate choice, some surgeons believe that literature on parathyroidectomy over the past two decades reveals a bias towards localization. Therefore, surgical expertise is more important than the search for abnormal parathyroid glands.


Author(s):  
Ahmad Alsayegh ◽  
Mohamad Bakhaidar ◽  
Alexander Winkler-Schwartz ◽  
Recai Yilmaz ◽  
Rolando F. Del Maestro

2021 ◽  
Vol 10 (22) ◽  
pp. 5263
Author(s):  
Thomas Boerner ◽  
Pompiliu Piso

Due to limited systemic treatment options, peritoneal carcinomatosis of gastric origin is still associated with a dismal outcome and is claimed a terminal disease. In the past, surgery had not been considered as a potential treatment option. However, there is emerging evidence that in selected patients, locoregional treatment modalities including cytoreductive surgery of peritoneal carcinomatosis can improve survival in patients with gastric cancer. These operative procedures are complex and challenging, and a high surgical expertise of the treating physician is necessary to prevent major postoperative morbidity and mortality with a delay of further systemic therapy. This review summarizes our current knowledge and personal experience regarding the techniques of cytoreductive surgery for peritoneal metastasis of gastric origin.


Author(s):  
Tripti Maithani ◽  
Madhuri Kaintura ◽  
Sharad Hernot ◽  
Kanika Arora

<p class="abstract">Gossypiboma is a dreaded event in surgical expertise. We report a case of post hemithyroidectomy gossypiboma removed 4 years post primary surgery. Initially suspecting it to be a tubercular abscess and fistula, we surprisingly found a surgical gauze on neck exploration. To understand the magnitude of this problem we assembled data on reported gossypibomas post neck surgeries. A detailed search of literature revealed 16 publications (20 cases) with varied clinical picture and differentials. Our case is only the fourth published case wherein there is such a long-standing history and the first to assemble data and review literature on exclusive neck gossypibomas. Although, neck is regarded as a confined cavity with very few obvious crevices where foreign body can be left behind iatrogenically; still, gossypiboma needs to be kept as a differential, especially with a previous surgical history.</p>


2021 ◽  
Vol 3 (1) ◽  
pp. 22-25
Author(s):  
Adekunle Olowu ◽  
Adel Abbas Alzehairy

Adrenal cysts are rare lesions that could be epithelial, endothelial, parasitic or haemorrhagic[1], as well as pseudocysts. Haemorrhagic adrenal cysts are extremely rare and are often asymptomatic, so diagnosis can be really challenging. This can prove really difficult for primary care physicians who are often the frontline clinicians these patients tend to present to. They are usually benign lesions and do not often cause mortality if detected early and prompt surgery is done, as was the case with the patient in our case report[4]. When they do become symptomatic, they can present with different systemic symptoms as documented in literature, including in our case report[2,4]. Diagnosis is usually through Ultrasound and CT Scan and management is largely laparoscopic or open excision depending on the size of the lesion, surgical expertise and local protocol. Most patients make full recovery and mortality is extremely low [3]. The aim of this review is to provide a broader overview of the subject, highlight salient points in several studies relating to haemorrhagic cysts, provide an up to date follow up information on the index patient in our case report and to explore possible areas for future study [4,6]. This review also includes a suggested management algorithm and intends to emphasize the fact that patients who present in primary, urgent or emergency care settings with persistent non-specific symptoms should be investigated for rare diseases.


Author(s):  
Andrzej Zyluk ◽  
Konrad Czernikiewicz ◽  
Joanna Antoniak ◽  
Urszula Abramczyk

Abstract Background Microsurgery is a specific surgical expertise that involves operating on very small structures, and requires the assistance of a magnifying device: a microscope or loupes. Several factors have been identified that could affect the quality of microsurgical performance in training or surgical procedures. Objective The objective of this study was to assess the impact of the selected factors – caffeine, alcohol and physical exercise – on a microsurgical task prior its performance. Methods Ten students from the 5th and 6th years of medical studies who had completed the advanced microsurgical course performed a “6-stitches test” on a latex glove spanned over a cup prior to and after consumption of caffeine, alcohol and performing physical exercises. The times taken to complete the task at baseline and post-exposure were recorded. Results The results of the study show a statistically significant positive effect of caffeine and a statistically significant negative effect of physical exercise on microsurgical performance when performed shortly before the task. Small dose of alcohol taken before the task showed had little effect on performance.


ESC CardioMed ◽  
2018 ◽  
pp. 1687-1687
Author(s):  
Michele De Bonis ◽  
Patrizio Lancellotti

Tricuspid stenosis is often combined with tricuspid regurgitation, most frequently of rheumatic origin. The choice between repair or valve replacement depends on valve anatomy and surgical expertise. Even though this is still a matter of debate, biological prostheses for valve replacement are usually preferred over mechanical ones.


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