Surg J R Coll Surg E
-
The patient safety imperative has raised expectations regarding the responsibility of medical educators and decision makers to ensure that physicians are competent. Ensuring that trainees are ready for independent practice upon graduation is challenged by reduced work hours such that trainees spend less time in the OR and perform fewer cases than desirable. ⋯ Trainee performance should be evaluated in a rigorous, reliable and meaningful way to ensure that graduates have the skills necessary for safe, independent practice.
-
Surg J R Coll Surg E · Aug 2014
Review Meta AnalysisDuodenopancreatectomy: open or minimally invasive approach?
Minimally invasive pancreaticoduodenectomy (MIPD) is a complex procedure, offered to selected patients at institutions highly experienced with the procedure. It is still not clear if this approach may enhance patient recovery and reduce postoperative complications comparing to open pancreaticoduodenectomy (OPD), as demonstrated for other abdominal procedures. ⋯ The MIPD procedure is feasible, safe, and effective in selected patients. MIPD may have some potential advantages over OPD, and should be performed and further developed by use in selected patients at highly experienced medical centers.
-
Whilst the steps for reacting to and communicating following a surgical error should be clear to all, actual practice is punctuated by a range of failures which lead to the harm done by the error being compounded by inadequacies in the disclosure and subsequent processes. This article outlines best practice at the current time within the United Kingdom when responding to a surgical error and it also reports the type of behaviours which result in poor levels of satisfaction from the patients' perspective - often resulting in litigation being invoked.
-
Surg J R Coll Surg E · Apr 2014
Review Meta AnalysisTotally extraperitoneal laparoscopic hernioplasty versus open extraperitoneal approach for inguinal hernia repair: a meta-analysis of outcomes of our current knowledge.
The aim of this article is to explore the clinical effects between open extraperitoneal approaches and totally extraperitoneal laparoscopic hernioplasty (TEP) in the repair of inguinal hernias. ⋯ Totally extraperitoneal laparoscopic hernioplasty (TEP) and open extraperitoneal mesh repair are equivalent in most of the analyzed outcomes. TEP is associated with shorter hospital stay, quicker return to normal activities or work, lower incidence of total postoperative complications and urinary problems, while the open extraperitoneal method has less incidence of peritoneal tears.
-
Surg J R Coll Surg E · Apr 2014
Review Meta AnalysisMeta-analysis of self-gripping mesh (Progrip) versus sutured mesh in open inguinal hernia repair.
This metaanalysis was designed to systematically analyse all published randomized controlled trials comparing self-gripping mesh (ProGrip) and sutured mesh to analyse early and long term outcomes for open inguinal hernia repair. ⋯ Self-gripping mesh was associated with shorter operative time compared to sutured mesh. Both types of mesh repairs have comparable perioperative and long term outcomes.