Personality traits and resident education preferences within general surgery.

Background: General surgery residents encounter a myriad of learning environments, each involving teaching styles that may or may not align with trainees' preferred learning styles. Moreover, trainees' preferred learning styles are likely influenced by their personality traits such as their degree of introversion/extraversion. We aimed to investigate general surgery residents' personality traits and how this may impact their preferred learning styles in various environments.

Impact of Robotic Surgery Objective Performance Indicators: A Systematic Review.

Objective intraoperative performance metrics are a new resource for the field of surgical data science. In this study, we conducted a comprehensive review to analyze the existing literature on robotic surgical objective performance indicators (OPIs). OPIs have been used to assess surgical skill and provide automated, objective feedback in multiple settings.

Robotic median arcuate ligament release: management algorithm and clinical outcomes from a large minimally invasive series.

Background: Median arcuate ligament syndrome (MALS) is a rare and debilitating condition that remains difficult to diagnose. Proper patient selection remains key to achieving favorable outcomes for those undergoing MALR. The robotic technique facilitates a minimally invasive MALR approach given the fine precision of the instrumentation and stability of visualization.

Capturing and Improving Case Charge Accuracy in Robotic Surgery Programs.

The robotic platform offers many benefits to patients and surgeons; however, incorporating this new surgical tool has also introduced challenges in intraoperative documentation accuracy. In 2019, we began to investigate our institution's robotic intraoperative supply documentation accuracy. We identified a 60% case error rate between the robotic items logged by the operating room staff in the electronic medical record and the true robotic items used for a case as logged on the Intuitive platform.

The epidemiology and biology of pulmonary metastases.

Our goal in this chapter is to explore the complex processes of metastasis and why there is a predisposition for this to occur in the lung. In addition, we aim to describe the incidence of pulmonary metastases in various contexts and based on the origin of the primary tumor. There are unique characteristics of the pulmonary system that make metastases more likely to occur in the lung than anywhere else in the body.

Different-team procurements: A potential solution for the unintended consequences of change in lung allocation policy.

The new lung allocation policy has led to an increase in distant donors and consequently enhanced logistical burden of procuring organs. Though early single-center studies noted similar outcomes between same-team transplantation (ST, procuring team from transplanting center) and different-team transplantation (DT, procuring team from different center), the efficacy of DT in the contemporary era remains unclear. In this study, we evaluated the trend of DT, rate of transplanting both donor lungs, 1-year graft survival, and risk of Grade 3 primary graft dysfunction (PGD) using the Scientific Registry of Transplant Recipient (SRTR) database from 2006 to 2018.

Donor management using a specialized donor care facility is associated with higher organ utilization from drug overdose donors.

Drug overdoses have tripled in the United States over the last two decades. With the increasing demand for donor organs, one potential consequence of the opioid epidemic may be an increase in suitable donor organs. Unfortunately, organs from donors dying of drug overdose have poorer utilization rates than other groups of brain-dead donors, largely due to physician and recipient concerns about viral disease transmission.

Impact of Nighttime Lung Transplantation on Outcomes and Costs.

Background: Previous studies in the field of organ transplantation have shown a possible association between nighttime surgery and adverse outcomes. We aim to determine the impact of nighttime lung transplantation on postoperative outcomes, long-term survival, and overall cost.

Methods: We performed a single-center retrospective cohort analysis of adult lung transplant recipients who underwent transplantation between January 2006 and December 2017.

Local versus distant lung donor procurement does not influence short-term clinical outcomes.

Objective: The purpose of this study was to recognize clinically meaningful differences in lung transplant outcomes based on local or distant lung procurement. This could identify if the lung allocation policy change would influence patient outcomes.

Methods: This single-center retrospective cohort study analyzed adult patients who underwent lung transplant from 2006 to 2017.

Robotic Approach to Paraesophageal Hernia Repair Results in Low Long-Term Recurrence Rate and Beneficial Patient-Centered Outcomes.

Background: Little is known regarding important long-term outcomes after robotic paraesophageal hernia (PEH) repairs, such as symptom relief and recurrence rates. The aim of this study was to evaluate the long-term clinical outcomes in a large series of patients undergoing robotic PEH repair.

Study Design: This prospective, IRB-approved study analyzed adult patients who underwent robotic PEH repair, from 2010 to 2014, at a high-volume tertiary academic medical center.

Favorable peri-operative outcomes observed in paraesophageal hernia repair with robotic approach.

Background: The robotic surgical approach offers enhanced visualization, dexterity and reach, which may facilitate the more technically demanding portions of paraesophageal hernia (PEH) repair such as hiatal reconstruction and mediastinal dissection. We sought to compare the peri-operative clinical outcomes of the laparoscopic vs. robotic approach to PEH repair.

Shipping Lungs Greater Distances Increases Costs Without Cutting Waitlist Mortality.

Background: On November 24, 2017, a change in lung allocation policy was initiated to replace the donor service area with a 250-nautical-mile radius circle around the donor hospital. We aim to analyze the consequences of this change, including organ acquisition cost and transplant outcomes, at the national level.

Methods: Data on adult patients undergoing lung transplantation between April 27, 2017, and June 22, 2018 (30 weeks before to 30 weeks after allocation policy change) were extracted from the Scientific Registry of Transplant Recipients database.

Effect of Patient Body Mass Index on Laparoscopic Surgical Ergonomics.

Background: Minimally invasive surgery may introduce new ergonomic challenges for surgeons. Increased patient body mass index (BMI) may further add to this ergonomic stress.

Objectives: The objective of this study was to quantify the ergonomic impact of patient BMI on surgeons during laparoscopic surgery.

Performance of Pediatric PROMIS CATs in Children With Upper Extremity Fractures.

This study was designed to quantify the performance of the pediatric Patient-Reported Outcome Measurement Information System (PROMIS) when delivered as part of routine care to children with upper extremity (UE) fractures. This cross-sectional study analyzed 964 new pediatric patients presenting with an UE fracture. All patients completed PROMIS computer adaptive tests for pain interference, peer relationships, UE function, and mobility domains at clinic registration.

Comparison of precision and speed in laparoscopic and robot-assisted surgical task performance.

Background: Robotic platforms have the potential advantage of providing additional dexterity and precision to surgeons while performing complex laparoscopic tasks, especially for those in training. Few quantitative evaluations of surgical task performance comparing laparoscopic and robotic platforms among surgeons of varying experience levels have been done. We compared measures of quality and efficiency of Fundamentals of Laparoscopic Surgery task performance on these platforms in novices and experienced laparoscopic and robotic surgeons.