RESUMO
PURPOSE: The use of robotic assisted surgery is increasing but training residents in its use may be associated with increased operative time and cost. The objective of this study is to compare the operative time of robotic incisional/ventral hernia repair (RIVHR) and robotic inguinal hernia repair (RIHR) when performed with and without a resident or fellow trainee. METHODS: A review of prospectively collected data was performed on all patients who underwent RIVHR and RIHR by a single surgeon over a 9-year period (2014-2023). Study variables included presence of trainee (resident or fellow), procedure time, console time, and recurrent hernia. Primary outcomes include procedure time and console time. RESULTS: A total of 402 surgeries were included for analysis. Residents assisted in 190 (47%) of the procedures, while fellows assisted in 97 (24%), and 115 (29%) were performed without a trainee. Median (IQR) console times in RIVHR assisted by fellows was 102 (72-145) minutes, compared to 90 (71-129) minutes among surgeries assisted by residents and 65 (52-82) minutes among surgeries performed without a trainee (p < 0.0001), a similar trend was observed for RIHR. The duration of hernia repair assisted by trainees was significantly longer than surgeries performed without a trainee. CONCLUSION: Operative time for RIVHR and RIHR is significantly lower when performed without a trainee. However, RIHR assisted by residents showed a consistent decrease in operative time over the 9-year period.
Assuntos
Hérnia Inguinal , Hérnia Ventral , Procedimentos Cirúrgicos Robóticos , Cirurgiões , Humanos , Fator IX , Hérnia Inguinal/cirurgia , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodosAssuntos
Diafragma/metabolismo , Fígado/metabolismo , Consumo de Oxigênio/efeitos dos fármacos , Esquistossomose/metabolismo , Esquistossomicidas/farmacologia , Animais , Diafragma/efeitos dos fármacos , Fígado/efeitos dos fármacos , Masculino , Camundongos , Oxamniquine/farmacologia , Oxamniquine/uso terapêutico , Schistosoma mansoni , Esquistossomose/tratamento farmacológico , Esquistossomicidas/uso terapêutico , Triazóis/farmacologiaRESUMO
The use of cerebral electrotherapy (CET) in methadone detoxification was studied in 28 patients. Fourteen patients received active CET; the other 14 acted as controls and received either stimulated CET or only methadone detoxification therapy. One patient dropped out of the study. The Taylor Manifest Anxiety Scale and the Hamilton Anxiety Scale were administered before and after the study period. Nine of the patients receiving active CET were drug-free by the end of 8 to 10 days, and all experienced a marked reduction of their symptoms; the control group did not show significant changes. CET was clearly beneficial in the treatment of patients undergoing methadone withdrawal.
Assuntos
Eletronarcose , Dependência de Heroína/reabilitação , Metadona , Síndrome de Abstinência a Substâncias/terapia , Adolescente , Adulto , Ansiedade/terapia , Estudos de Avaliação como Assunto , Humanos , Masculino , Escala de Ansiedade Manifesta , Pessoa de Meia-Idade , Transtornos do Sono-Vigília/terapia , Fatores de TempoRESUMO
A new method of treatment of vaginismus by using intravenous diazepam abreaction interviews is reported. Four patients between the ages of 19 and 28 were interviewed. The duration of their main complaint varied from 6 months to 3 years. Three to six abreaction interviews were conducted; the maximum dosage of Valium used was from 20-30 mg. All of these patients reported having successful intercourse after these interviews. Individual psychotherapy continued after the interviews on a weekly basis, and marital therapy on a monthly basis, for a period of 2 to 6 months. Three out of four women reported being orgasmic for the first time. It is the opinion of the author that this new method of treatment of vaginismus is greatly beneficial.