Feature Channels: Surgery

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Only a small fraction of transplant centers nationwide are willing to accept and transplant deceased-donor kidneys that they perceive as less than perfect, leading to lengthy, organ-damaging delays as officials use a one-by-one approach to find a willing taker. Now, Johns Hopkins researchers have designed a formula they say can predict which donor kidneys are most likely to be caught in that process, a method that could potentially stop thousands of usable kidneys each year from being discarded because it took too long for them to be transplanted. Previous studies have shown such kidneys can extend the life of certain dialysis patients, if allocated and transplanted in a timely manner.

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A 5-month-old New York infant received a lifesaving liver transplant for advanced liver failure diagnosed following her birth 10 weeks premature. One of the smallest babies ever to successfully receive a liver transplant, she weighed 4 pounds at the time of the surgery.

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Nick Van Erp’s high school sports career ended prematurely when he tore the anterior cruciate ligament in his knee during a spring lacrosse game his freshman year of high school, leading him to two failed repair surgeries before coming to the University of Michigan for his third. His story is not unique-18,000 to 35,000 ACL repairs will fail a year, requiring additional surgery which is more complicated, less successful and requires a longer rehabilitation period. Physicians at the University of Michigan say multiple factors attribute to a failed repair and they caution patients to inquire about their surgeons’ previous experience with the procedure.

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Foot and ankle surgeons are warning patients of the risks of "foot facelifts."

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A study by investigators at Case Western Reserve University School of Medicine published in this week’s issue of JAMA found that public hospital comparison data reported by the U.S. Department of Health and Human Services does not accurately correlate with a patient’s risk for surgical postoperative infection.

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An analysis of data on adherence to surgical care improvement measures finds that when analyzed as a composite infection-prevention score, the improvement measures were associated with a lower probability of postoperative infection. However, adherence to individual measures – the format of publicly reported performance data – was not associated with a significantly lower risk of infection, according to a study in the June 23/30 issue of JAMA.

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Surgeons are studying a new way to make kidney donation safer, less invasive and almost scar free for women by using a new technique that removes kidneys transvaginally.

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One year after weight loss surgery with laparoscopic gastric banding, extremely obese adults demonstrate not only better physical health but also improved psychological health, a new study shows. The results will be presented Monday at The Endocrine Society’s 92nd Annual Meeting in San Diego.

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Restoring people’s health and returning them to their daily lives as soon as possible is the goal following any surgery. When a person’s ability to eat and speak is affected, as with cancer in the mouth, surgery is particularly disruptive, creating a greater challenge. A one-step surgery can remove cancerous tissue and reconstruct bone and teeth functionality immediately, positively impacting the patient’s quality of life.

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A new Cochrane review finds that exercise programs help patients recover shoulder movement and minimize loss of arm or shoulder function after breast cancer surgery.

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Head and neck cancer surgeons at UT Southwestern Medical Center performed the area’s first transoral robotic surgery (TORS), a recently approved minimally invasive no-scar procedure to remove tumors in the throat.

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Surgeons at the University of Illinois at Chicago report the first successful robotic kidney transplant in a morbidly obese patient.

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Major amputation is often selected over infrainguinal bypass in patients with severe systemic comorbidities because of a presumed decrease in risk of perioperative morbidity and mortality. To investigate this presumption, researchers from the Division of Vascular and Endovascular Surgery at the Brigham and Women’s Hospital in Boston undertook a risk-adjusted comparison of early postoperative morbidity and mortality of high-risk patients undergoing infrainguinal bypass and major amputation. Results of this study will be presented today at the Society of Vascular Surgery’s 64th Vascular Annual Meeting.

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Patients with abdominal aortic aneurysms (AAAs) of less than 5.5 cm have no significant differences in clinical outcomes after endovascular repair (EVAR) than those with larger AAAs according to data from a five-year prospective clinical trial setting. The researchers maintain their recommendation that small aneurysms should not be treated surgically. Details of this study were presented at the 64th Vascular Annual Meeting presented by the Society for Vascular Surgery.

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A regional quality improvement effort aimed at increasing the use of preoperative beta-blocker (BB) usage to help prevent postoperative myocardial infarction (POMI) was revealed today at the 64th Vascular Annual Meeting® presented by the Society for Vascular Surgery®.

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Vascular surgery may be accompanied by cardiovascular complications, like ventricular tachyarrhythmia (VT). Though, these arrhythmias initially might be asymptomatic, they can lead to increased risk for late sudden cardiac death after surgery. Researchers from the Netherlands believe that cardiac high-risk patients with new-onset perioperative VT might benefit from preemptive cardioverter defibrillator (ICD) implantation in addition to optimal focused medical therapy.

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Interrupting the blood flow for more than 20 to 25 minutes during kidney cancer surgery leads to a greater risk for patients developing chronic kidney disease, a Mayo Clinic and Cleveland Clinic collaborative research team has found. The study was published today in the journal, European Urology.

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Prior failed ipsilateral percutaneous vascular intervention (PVI) in patients with critical limb ischemia (CLI) predicts poor outcome after lower extremity bypass (LEB), according to a study from the 64th Vascular Annual Meeting presented by the Society for Vascular Surgery®.

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Duplex guided dialysis access angioplasty can be performed safely and effectively in the office setting according to a new study presented today at the 64th Vascular Annual Meeting presented by the Society for Vascular Surgery®. According to researchers, ultrasound offers the advantage of treating the patient without ionizing radiation and sedation or iodinated contrast.

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The American College of Surgeons Health Policy Research Institute has released a new publication that maps the surgeon supply across the United States.

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Physicians at UT Southwestern Medical Center are the first in North Texas to use the newest generation surgical robot, the dual-console DaVinci Surgical System, enabling them to perform minimally invasive surgeries with even greater precision.

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A new study, presented at the 64th Vascular Annual Meeting presented by the Society for Vascular Surgery® today, assessed the accuracy of indirect estimated radiation doses of 47 patients during endovascular thoracoabdominal aneurysm repair (eTAAA ).

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Surgeons at Johns Hopkins have safely and effectively operated inside the brains of a dozen patients by making a small entry incision through the natural creases of an eyelid to reach the skull and deep brain.

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An assessment of nearly 70 ambulatory surgical centers in three states found that lapses in infection control were common, including for practices such as hand hygiene, injection and medication safety and equipment reprocessing, according to a study in the June 9 issue of JAMA.

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A Phase III trial of a drug used for the treatment of vitreomacular adhesion (VMA) and macular hole (MH) revealed key findings for patients diagnosed with these severe conditions which can lead to significant vision impairment.

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Researchers have found that less bone loss is experienced in an oral implant when a two-stage approach to surgery is used. Simultaneously inserted implants, which require one operation to transplant bone tissue and to insert implants into the jawbone, have shown excellent results. However, when the implants were inserted in a second operation about six months after the bone tissue grafts, crestal bone loss was reduced.

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A minimally invasive technique used to destroy kidney tumors with an electrically controlled heating probe showed similar effectiveness as surgical removal of tumors in curbing cancer recurrence rates for up to five years after treatment.

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Two Buffalo scientists have paired up to create technology that has the potential to revolutionize surgical training worldwide, developing the first procedure-based, hands-on surgical training software. Their patent-pending system, Hands-On Surgical Training ™ (HOST), guides surgeons through real-time operative procedures using the Robotic Surgical Simulator ™ (RoSS) interface.

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A new surgery that can get people with foot drop out of a brace and walking normally.

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Transplant surgeons at Johns Hopkins who have reviewed the medical records of more than 20,000 heart transplant patients say that it is not simply racial differences, but rather flaws in the health care system, along with type of insurance and education levels, in addition to biological factors, that are likely the causes of disproportionately worse outcomes after heart transplantation in African Americans.

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A compound found in sunless tanning spray may help to heal wounds following surgery, according to new results published by plastic surgeons from NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City and biomedical engineers at Cornell University in Ithaca, N.Y., where the novel compound was developed.

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A 17-year-long community study looking at symptoms of enlarged prostate in over 2,000 men age 40 to 79 years suggests that surgery for benign prostatic hyperplasia (BPH) offers more relief from incontinence and obstruction symptoms than treatment from drug-based therapy, according to a new study by researchers at Mayo Clinic.

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Physicians now have two safe and effective options to treat their patients at risk for stroke, says a researcher at Mayo Clinic who led a large, NIH-funded, national clinical trial testing surgery or use of a stent to open a blocked carotid artery.

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The use of modified measles virus may represent a new treatment for a childhood brain tumor known as medulloblastoma, according to a new study appearing in Neuro-Oncology.

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The number of bariatric surgeries in the U.S. skyrocketed from 13,386 in 1998 to 220,000 in 2008, but a new study released today by HealthGrades, the leading independent healthcare ratings organization, finds that the nation’s hospitals have wide variances in both complication rates and lengths of stay, which largely correlate with the number of times the hospital performs bariatric procedures.

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A less invasive, surgical treatment for bunions known as the Mini TightRope procedure is being used at Rush University Medical Center to correct bunions, or hallux valgus, a common, often painful deformity in which the big toe is angled in toward the smaller toes.

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Symptomatic heart failure prior to surgery is routinely acknowledged as a risk factor for adverse outcomes for both cardiac and non-cardiac surgeries. In a new study published in the June Anesthesiology, researchers delve further into the implications of cardiac problems on postoperative outcomes, exploring preoperative diagnosis and impact of asymptomatic left ventricular (LV) dysfunction in vascular surgery patients.

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A nationwide study has confirmed the benefit of giving estrogen-lowering drugs before surgery to breast cancer patients. The treatment increased the likelihood that women could undergo breast-conservation surgery, also called lumpectomy, instead of mastectomy.

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Receiving an organ low in weight in relation to the recipient’s body weight increases kidney transplant recipients risk of complications and transplant failure, according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results suggest that compatibility between a donated kidney’s weight and the weight of the recipient could improve the success of transplantation.

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In the United States over 80,000 people are on the kidney transplant waiting list, and thousands die each year waiting for transplants. For most dialysis patients, kidney transplantation increases their chances of survival. In a study appearing in an upcoming issue of the Journal of the American Society of Nephrology, Maarten G. Snoeijs, MD (Maastricht University Medical Center, the Netherlands) and co-authors analyzed 2,575 Dutch transplant candidates to see how receiving a DCD kidney affected their overall chances of survival.

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A study by a pediatric surgical oncologist from The University of Texas MD Anderson Children's Cancer Hospital shows that an adult surgery adapted for use in young patients increased the survival of children with rare tumors in the abdomen.

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Preoperative statin therapy has a protective effect on patients undergoing elective abdominal aortic aneurysm (AAA) repair that reduces risk and subsequent total hospital costs according to a new study from researchers at the East Carolina Heart Institute in Greenville, North Carolina.

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Designed to stop the motion at a painful vertebral segment, this procedure is traditionally performed via a large incision on the back, stripping vital muscles away from the spine.

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Early tracheotomy in ICU patients on mechanical ventilation (MV) did not reduce mortality when compared to later tracheotomy in a study of cardiac surgery patients requiring prolonged ventilation in a Paris study.

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The immunosuppressive drug sirolimus considerably improves the kidney health of patients with autosomal dominant polycystic kidney disease (ADPKD), according to a study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN). The results suggest that this agent may be a promising treatment option for patients with ADPKD—the most common genetic kidney disease and a major cause of kidney failure.

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A new weight reduction surgical option is now available through the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital. The newest surgical weight loss procedure offered by the Center is the “gastric sleeve,” named as such because a large part of the stomach is removed and the remainder is closed to make a tube-like “sleeve.”

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Surgical procedure is less traumatic, requires shorter hospital stay, results in quicker recovery.

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University of Michigan C.S. Mott Children’s Hospital is the first in the state to offer procedure.

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A simple, 10-minute “frailty” test administered to older patients before they undergo surgery can predict with great certainty their risk for complications, how long they will stay in the hospital and — most strikingly — whether they are likely to end up in a nursing home afterward, new research from Johns Hopkins suggests.

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New training programs and an increase in funding will be required to meet the growing need for general surgeons. Current residency programs do not have the capacity to address the growing shortage of general surgeons, according to survey research presented today at the Sixth Annual American Association of Medical Colleges (AAMC) Physician Workforce Research Conference in Alexandria, Va.