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Although some researchers have reported health-related benefits of marijuana, others have reported adverse side effects in nearly every organ system. Patterns of marijuana use are evolving, as is researchers' understanding of marijuana use for healthcare. Despite these findings and developments, nurse anesthetists are inadequately educated about marijuana's perioperative effects on endosurgical patients. As a result, many nurse anesthetists lack confidence in and knowledge of the perioperative care of endosurgical patients under the influence of marijuana. This lack of confidence and knowledge limits the ability of nurse anesthetists to provide optimal care, threatens patient safety, and potentially impairs surgical outcomes. To improve the confidence and perceived knowledge of certified registered nurse anesthetists (CRNAs) regarding perioperative care of endosurgical patients who use marijuana, a quality improvement project was conducted in a metropolitan endosurgical center in California. After the project, participating CRNAs (N = 15) reported increased confidence ( = -0.982; = .325, > .05) and significantly improved perceived knowledge ( = -3.04; = .002, < .05) regarding care of patients who use marijuana. For endosurgical patients who used marijuana prior to their procedure, knowledgeable and confident anesthesia care for the side effects of marijuana substantially improved the quality of care, communication, and reduced cancellations.
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Surg Endosc
August 2025
Houston Colon Foundation, Houston, TX, USA.
Background: The robotic NICE procedure (Natural Orifice IntraCorporeal Anastomosis with Transrectal Extraction) has emerged as an innovative approach for left-sided colorectal resections. In this procedure, specimen extraction and completion of anastomosis are performed without abdominal wall incision, improving patient outcomes and potentially reducing healthcare costs.
Objective: This study aims to evaluate the cost-effectiveness of the robotic NICE procedure compared to open, laparoscopic, and robotic surgical approaches for left-sided colorectal resections.
J Robot Surg
June 2025
Houston Colon Foundation, Houston, TX, USA.
The robotic NICE procedure is a novel minimally invasive approach in colorectal surgery, yet its learning curve remains undefined; this study aimed to define its distinct phases by analyzing operative time trends. A retrospective review of 170 consecutive NICE procedures performed by a single surgeon between May 2018 and August 2019 was undertaken. Skin-to-skin operative time was the learning curve surrogate and plotted with unadjusted and risk-adjusted cumulative sum (CUSUM) analyses.
View Article and Find Full Text PDFJ Pediatr Surg
January 2025
Pediatric Airway Unit & Division of Pediatric Surgery, University Hospital 12 de Octubre, Complutense University of Madrid, School of Medicine, Madrid, Spain. Electronic address:
Background: The aim of this study was to determine the incidence of complications after thoracoscopic lobectomy in children according to a verified classification. Secondary aim was to evaluate the modifications made in our management protocol in order to decrease the rate of complications.
Methods: Retrospective study of pediatric patients in whom a lobectomy was performed for congenital lung malformation (CLM) in our institution between 2003 and 2021.
Surg Endosc
January 2025
Medical Director UnityPoint Clinic Weight Loss Specialists, University of Iowa, West Des Moines, IA, USA.
Surg Endosc
December 2024
Houston Colon Foundation, Houston, TX, USA.
Background: By 2030, projections indicate that nearly half of USS adults will be obese, with 29 states exceeding a 50% obesity rate. High Body Mass Index (BMI) presents particular challenges in treating diverticulitis, including worsened symptoms and increased risk of surgical complications. The Robotic Natural orifice Intracorporeal Anastomosis with Transrectal Extraction (NICE) procedure has been developed for colorectal surgeries to tackle these challenges.
View Article and Find Full Text PDF