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Operative Experience (operative + experience)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Operative experience in the Victorian general surgical training programme

ANZ JOURNAL OF SURGERY, Issue 12 2003
Kenneth Wong
Background: The Royal Australasian College of Surgeons recommends minimum operative and endoscopy training requirements for advanced trainees in general surgery. This study examines the influences of trainee seniority, geographical location of surgical rotation, and surgeons' remuneration arrangements on the operative and endoscopy experiences of general surgical trainees in Victoria. Methods: Trainee log books covering two 6-month training periods in the year 2001 were analysed for depth and breadth of reported operative and endoscopy experience. Results: A total of 81 trainee log books was reviewed. Senior trainees were significantly more likely to have a higher primary operator experience. Total operative caseload and primary operator experience, in terms of major operative cases, were greater in rural rotations. Endoscopy experience was significantly greater in rural rotations. Operative exposure to gynaecological, laparoscopic, orthopaedic, paediatric and plastic surgical procedures was significantly greater in rural rotations. Surgeons' remuneration arrangements were not significantly related to trainee operative experience. Conclusions: Rural surgical rotations enhance the depth and breadth of operative experience of Victorian general surgical registrars, allowing greater exposure to subspecialty surgical procedures. [source]

Single-port, single-operator-light endoscopic robot-assisted laparoscopic urology: pilot study in a pig model

BJU INTERNATIONAL, Issue 5 2010
Sebastien Crouzet
Study Type , Therapy (case series) Level of Evidence 4 OBJECTIVES To present our initial operative experience in which single-port-light endoscopic robot-assisted reconstructive and extirpative urological surgery was performed by one surgeon, using a pig model. MATERIALS AND METHODS This pilot study was conducted in male farm pigs to determine the feasibility and safety of single-port, single-surgeon urological surgery. All pigs had a general anaesthetic and were placed in the flank position. A 2-cm umbilical incision was made, through which a single port was placed and pneumoperitoneum obtained. An operative laparoscope was introduced and securely held using a novel low-profile robot under foot and/or voice control. Using articulating instruments, each pig had bilateral reconstructive and extirpative renal surgery. Salient intraoperative and postmortem data were recorded. Results were analysed statistically to determine if outcomes improved with surgeon experience. RESULTS Five male farm pigs underwent bilateral partial nephrectomy and bilateral pyeloplasty before a completion bilateral radical nephrectomy. There were no intraoperative complications and there was no need for additional ports to be placed. The mean (range) operative duration for partial nephrectomy, pyeloplasty, and nephrectomy were 120,(100,150), 110,(95,130) and 20,(15,30),min, respectively. The mean (range) estimated blood loss for all procedures was 240,(200,280),mL. The preparation time decreased with increasing number of cases (P = 0.002). CONCLUSIONS The combination of a single-port, a robotic endoscope holder and articulated instruments operated by one surgeon is feasible. With a single-port access, the robot allows more room to the surgeon than an assistant. [source]

Clinical significance of suprascapular nerve mobilization

CLINICAL ANATOMY, Issue 8 2005
Kale D. Bodily
Abstract The anatomy of the suprascapular nerve is important to surgeons when focal nerve lesions necessitate surgical repair. Recent experience with a patient who had a complete suprascapular nerve lesion in the retroclavicular region (combined with axillary and musculocutaneous nerve lesions) is presented to illustrate that successful direct nerve repair is possible despite resection of a neuroma. Specifically, we found that neurolysis and mobilization of the suprascapular nerve and release of the superior transverse scapular ligament provided the necessary nerve length to achieve direct nerve repair after the neuroma was removed. A combined supraclavicular and infraclavicular approach to the suprascapular nerve provided excellent visualization, especially in the retroclavicular region. Postoperatively, the patient recovered complete shoulder abduction and external rotation with the direct repair, an outcome uncommonly achieved with interpositional grafting. Based on our operative experience, we set out to quantify the length that the suprascapular nerve could be mobilized with neurolysis. Mobilization of the nerve and release of the superior transverse scapular ligament generated an average of 1.6 cm and 0.7 cm of extra nerve length respectively, totaling 2.3 cm of additional usable nerve length overall. The ability to expose the suprascapular nerve in the retroclavicular/infraclavicular region and to mobilize the suprascapular nerve for possible direct repair has not been previously emphasized and is clinically important. This surgical approach and technique permits direct nerve repair after resection of a focal neuroma in the retroclavicular or infraclavicular region, thus avoiding interpositional grafting, and improving outcomes. Clin. Anat. 18:573,579, 2005. © 2005 Wiley-Liss, Inc. [source]