Comparative Outcomes of Direct Versus Mesh Repair and Timing of Repair for Traumatic Abdominal Wall Hernias: A Systematic Review and Meta-Analysis.

Introduction: Traumatic abdominal wall hernia (TAWH) refers to the disruption of the muscular layers of the abdominal wall following blunt traumatic injury. There is a lack of consensus in the management of TAWH, particularly when trauma laparotomy for concurrent visceral injury is required. This systematic review and meta-analysis aims to evaluate recurrence outcomes with repair technique (mesh vs.

A Scoping Review on the Data Utility, Clinical Impact, and Cost of Multidisciplinary Team Meetings for Pancreatic Cancer.

Background: Multidisciplinary Team Meetings (MDMs) are the accepted model for constructing treatment plans for pancreatic cancer (PC). With increasing PC diagnoses and budget constraints, MDMs must undertake cost-effective workflows. We aimed to summarize available evidence on the utility of information collected, their impact on care decisions, and cost burden.

Implementation of trans-cystic biliary stenting during acute cholecystectomy to facilitate elective ERCP: a quality improvement initiative.

Background: A predominantly endoscopic approach for acute admissions with choledocholithiasis with a gallbladder in situ (CGIS) resulted in prolonged hospital length of stay due to delays at investigation and treatment junctures. We initiated a quality improvement program of trans-cystic biliary stenting to facilitate efficient patient progress to acute cholecystectomy and outpatient ERCP if required.

Methods: We utilized implementation frameworks with regular re-assessment for this quality improvement project.

Near-Peer Coaching to Enhance Operative Learning: An Educational Innovation for Surgical Training.

Objective: To design, implement, and evaluate a near-peer coaching model to enhance operative learning in general surgery training.

Background: There is an urgent need to maximize operative learning in surgical education. Trainees find barriers to operative learning difficult to navigate and often sacrifice educational opportunities for the sake of impression management.

Role of neoadjuvant peptide receptor radionuclide therapy in unresectable and metastatic gastro-entero-pancreatic neuroendocrine neoplasms: A scoping review.

Peptide receptor radionuclide therapy (PRRT) is an established therapy for metastatic neuroendocrine neoplasms (NEN). The role of PRRT as a neoadjuvant treatment prior to surgery or other local therapies is uncertain. This scoping review aimed to define the landscape of evidence available detailing the utility of PRRT in the neo-adjuvant setting, including the clinical contexts, efficacy, and levels of evidence.

Paradigms in trauma laparoscopy for anterior abdominal stab wounds: A scoping review.

Introduction: Anterior abdominal stab wounds (AASW) are a heterogeneous presentation with evolving management over time and heterogenous practice between centres. The aim of this scoping review was to identify, characterise and classify paradigms for trauma laparoscopies for AASW.

Methodology: Studies were screened from Embase, Medline, Scopus, Cochrane Library and Web of Science from 1 January 1947 until 1 January 2023.

Reducing Preoperative Fasting Through Technology and Education in an Acute General Surgical Adult Cohort.

Background: Despite widespread support for reduced fasting protocols prior to anesthesia, the traditional "fast from midnight" (FFMN) remains widely employed. This study implemented a pilot preoperative fasting reduction program for patients booked for acute surgery in the Department of General Surgery at a busy metropolitan tertiary hospital, including use of an electronic health record (EHR)-based solution, aiming to measure effect on fasting times and use of intravenous fluid (IVF).

Methods: A pilot program was implemented in August 2021 in the Emergency General Surgery (EGS) unit at the Royal Melbourne Hospital, Australia.

Relationship between medical programme progress test performance and surgical clinical attachment timing and performance.

Purpose: Progress tests (PTs) assess applied knowledge, promote knowledge integration, and facilitate retention. Clinical attachments catalyse learning through an appropriate learning context. The relationship between PT results and clinical attachment sequence and performance are under-explored.

Comparison of risk adjusted excess post-operative pancreatic fistula rates after pancreaticoduodenectomy using cumulative sum analysis.

Background: Post-operative pancreatic fistula (POPF) is a key outcome post pancreaticoduodenectomy. There are numerous POPF risk calculators but no agreed benchmark, a key component of meaningful audit. We compared observed versus predicted POPF for six risk adjusted POPF calculators, to ascertain how they differ and thus contribute to discussion around benchmarking.

Adjuvant Chemotherapy in the Treatment of Intraductal Papillary Mucinous Neoplasms of the Pancreas: Systematic Review and Meta-Analysis.

Background: The present systematic review aimed to compare survival outcomes of invasive intraductal papillary mucinous neoplasms (IIPMNs) treated with adjuvant chemotherapy versus surgery alone and to identify pathologic features that may predict survival benefit from adjuvant chemotherapy.

Method: A systematic search of MEDLINE, PubMed, Scopus, and EMBASE was performed using the PRISMA framework. Studies comparing adjuvant chemotherapy and surgery alone for patients with IIPMNs were included.

A systematic scoping review of the initial experience with laparoscopic radical antegrade modular pancreatosplenectomy for pancreatic malignancy.

Background: Laparoscopic radical antegrade modular pancreatosplenectomy (L-RAMPS) is a validated surgical approach for the surgical treatment of pancreatic malignancies of the body and tail of the pancreas. Open (O-) RAMPS is an established technique that offers oncological efficacy and acceptable post-operative outcomes when compared to standard distal pancreatectomy for pancreatic malignancies. This review aimed to determine the types of evidence available for L-RAMPS, and its selection criteria and reported outcomes, using systematic scoping review methodology.

Systematic review and meta-analysis of risk factors of postoperative pancreatic fistula after distal pancreatectomy in the era of 2016 International Study Group pancreatic fistula definition.

Background: Risk factors for the development of clinically relevant POPF (CR-POPF) following distal pancreatectomy (DP) need clarification particularly following the 2016 International Study Group of Pancreatic Fistula (ISGPF) definition.

Methods: A systemic search of MEDLINE, Pubmed, Scopus, and EMBASE were conducted using the PRISMA framework. Studies were evaluated for risk factors for the development CR-POPF after DP using the 2016 ISGPF definition.

Operative experience in essential emergency general surgery procedures: is autonomy achievable during surgical training?

Background: Readiness for practice is an ongoing concern in surgery. Surgeons who have completed general surgery training are expected to be proficient in performing common emergency procedures. The aim of this study was to assess the experience and autonomy of general surgery trainees in New Zealand in 10 emergency general surgery procedures, and identify factors associated with reaching primary operator (PO) thresholds.

Synchronous Liver Resection, Cytoreductive Surgery, and Hyperthermic Intraperitoneal Chemotherapy for Colorectal Liver and Peritoneal Metastases: A Systematic Review and Meta-analysis.

Background: Synchronous liver resection, cytoreductive surgery, and hyperthermic intraperitoneal chemotherapy for colorectal liver and peritoneal metastases have traditionally been contraindicated. More recent clinical practice has begun to promote this aggressive treatment in select patients.

Objective: This study aimed to investigate the perioperative and oncological outcomes of patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy, with and without liver resection, in the management of metastatic colorectal cancer.

Learning in the Operating Theatre: A Thematic Analysis of Opportunities Lost and Found.

Objective: The operating theatre (OT) is an important learning environment. Trainees face barriers to learning in the OT that may reduce meaningful educational interactions. The impact of these barriers on the intraoperative learning experience of trainees and the strategies that they employ to overcome them are not known.

Benchmarking Performance in Pancreatic Surgery: a Systematic Review of Published Quality Metrics.

Background: Pancreatic surgery is performed in relatively few centres. There are validated quality benchmarks for pancreatic surgery, although it remains unclear how published benchmarks compare with each other. This study aimed to systematically review published literature to summarise metrics that define quality benchmarks for pancreatic surgery.

Epidural Versus Transabdominal Wall Catheters: A Comparative Study of Outcomes After Pancreatic Resection.

Background: This study compared epidural analgesia with local anesthetic administration via transabdominal wall catheters (TAWC), to determine the effect on perioperative outcomes in pancreatic surgery.

Materials And Methods: A retrospective review of patients undergoing open pancreatic surgery at Auckland City Hospital from 2015 to 2018 was undertaken. Data collected included patient demographics, type of perioperative analgesia, intravenous fluid and vasopressor use, length of high dependency unit stay, postoperative complications, and length of hospital stay.

Assessment of Autonomy in Operative Procedures Among Female and Male New Zealand General Surgery Trainees.

Importance: The need for trainee sex equality within surgical training has resulted in an appraisal of the training experience in the New Zealand general surgery training program.

Objective: To investigate the association between trainee sex and surgical autonomy in the operating room in the New Zealand general surgery training program.

Design, Setting, And Participants: Retrospective cohort study conducted from December 10, 2012, to December 10, 2017, examining all endoscopic, major, and minor procedures performed by all New Zealand general surgery trainees in every training hospital in New Zealand.

Assessing the risk of viral infection from gases and plumes during intra-abdominal surgery: a systematic scoping review.

Background: The aim of this study was to identify the current evidence regarding the risk of acquiring viral infections from gases or plumes during intra-abdominal surgery. Peritoneal fluids may contain cellular material and virus particles. Electrocautery smoke and plumes from energy devices may aerosolize harmful substances and viral particles.

A Network Meta-analysis of Surgery for Chronic Pancreatitis: Impact on Pain and Quality of Life.

Background: The surgical operation associated with improved pain and quality of life (QoL) in patients with chronic pancreatitis (CP) is unknown.

Method: The Scopus, EMBASE, Medline and Cochrane databases were systematically searched until May 2019, and all randomised trials (RCTs) comparing surgical operations for CP pain were included in a network meta-analysis (NMA).

Results: Four surgical operations for treating CP were directly compared in eight RCTs including 597 patients.

Use of social media for surgical education in Australia and New Zealand.

Background: Social media are an increasingly important tool for educators, although their use for surgical education in Australia and New Zealand (ANZ) has not been quantified. This study aimed to determine the social media presence of surgical training institutions in ANZ, quantify the proportion of their social media content that is educational, compare engagement between educational and non-educational content, and determine perspectives on using social media for education.

Methods: An online search was conducted in October 2018 to determine the social media presence of surgical training institutions accredited to deliver under- and post-graduate surgical education in ANZ.