Thoracic surgery clinics
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Thoracic surgery clinics · Feb 2020
ReviewAnatomic Segmentectomy in Nonintubated Video-Assisted Thoracoscopic Surgery.
Thoracic surgery has evolved into minimally invasive surgery, in terms of not only surgical approach but also less aggressive anesthesia protocols and lung-sparing resections. Nonintubated anatomic segmentectomies are challenging procedures but can be safely performed if some essentials are considered. Strict selection criteria, previous experience in minor procedures, multidisciplinary cooperation, and the 4 cornerstones (deep sedation, regional analgesia, oxygenation support and vagal blockade) should be followed. Better outcomes in postoperative recovery, including resumption of oral intake, chest tube duration, and hospital stay, and low complication and conversion rates, are encouraging but should be checked in larger multicenter prospective randomized trials.
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The introduction of minimally invasive techniques to the field of foregut surgery has revolutionized the surgical approach to giant paraesophageal hernia repair. Laparoscopy has become the standard approach in patients with giant paraesophageal hernia because it has been shown to be safe and is associated with lower morbidity and mortality when compared with various open approaches. ⋯ This is despite a rise in comorbid conditions associated with this patient population. This article describes our operative approach to laparoscopic giant paraesophageal hernia repair.
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Thoracic surgery clinics · Aug 2019
ReviewFaculty Development: Using Education for Career Advancement.
Faculty development is important at any level of academic rank but is especially important in early stages. The clinical educator is a rewarding pathway that is emerging as a special track for promotion and advancement. Success is achievable through development of skills, measurement of progress, obtaining funding, and completion of projects through publication. Advanced degrees, mentorship, and persistence are keys to achievement.
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Thoracic surgery clinics · Aug 2019
ReviewUnconscious Bias: Addressing the Hidden Impact on Surgical Education.
Unconscious (or implicit) biases are learned stereotypes that are automatic, unintentional, deeply engrained, universal, and able to influence behavior. Several studies have documented the effects of provider biases on patient care and outcomes. ⋯ Presented is the background related to some of the more common unconscious biases and effects on medical students, resident trainees, and academic faculty. Finally, targeted strategies are highlighted for individuals and institutions for identification of biases and the means to address them.
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Surgical training has focused on the development of technical competency. Interpersonal and cognitive skills are essential to working as an interdisciplinary team, which translates into safety for the patient and well-being for the surgeon and colleagues. This article offers an "alternative" surgical curriculum topic list to augment the technical skill sets traditionally taught to trainees.