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1.
Rehabilitación (Madr., Ed. impr.) ; 58(2): 1-9, abril-junio 2024. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-232114

RESUMO

Introduction: The anterior cruciate ligament (ACL) is the most frequently injured ligament of the knee. However, quantitative studies on evaluate the postural control influence resulted from the ACL remnant preservation or not are scarce. The aim of this study is to evaluate the postural control of patients submitted to ACL reconstruction with and without preservation of the injured remnant in pre and postoperative periods.MethodsEighteen patients underwent ACL reconstruction and separated into 2 groups according to the preservation or not of the remnant: (I) submitted to ACL reconstruction with preservation of the remnant (10 patients); (II) submitted to ACL reconstruction without preservation of the remnant (8 patients). They were assessed using the Lysholm score and force plate, which evaluated the patient's postural stability for remnant and non-remnant preservation in ACL reconstruction surgery.ResultsGroup I showed statistically significant subjective and objective improvements, both at 3 and 6 months. Additionally, improvement of the Lysholm test at 6 months in Group II was also statistically significant. Furthermore, the results of the Friedman test for the VCOP and VY variables of Group I, with support of the injured side in the force plate, showed a statistically significant difference both for pre and postoperative period at 3 months, compared to the 6-month postoperative period. The variables EAC and VX were statistically different for Group II, considering the preoperative period, 3 and 6 months postoperatively.ConclusionPreserving the ACL remnant in patients with ACL injuries has a positive impact on postural stability during recovery.(AU)


Introducción: El ligamento cruzado anterior (LCA) es el ligamento de la rodilla que se lesiona con mayor frecuencia. Sin embargo, escasean los estudios cuantitativos sobre la evaluación de la influencia del control postural derivada de la preservación, o no, del remanente del LCA. El objetivo de este estudio es evaluar el control postural de los pacientes sometidos a la reconstrucción del LCA, con y sin preservación del remanente lesionado, en los periodos previo y posterior a la cirugía.MétodosDieciocho pacientes sometidos a reconstrucción del LCA separados en 2 grupos, de acuerdo con la preservación o no preservación del remanente: I) sometidos a reconstrucción del LCA con preservación del remanente (10 pacientes), y II) sometidos a reconstrucción del LCA sin preservación del remanente (8 pacientes). Los pacientes fueron evaluados utilizando la puntuación de Lysholm y una placa de aplicación de fuerza, que evaluó la estabilidad postural del paciente para la preservación y no preservación del remanente en la cirugía de reconstrucción del LCA.ResultadosEl grupo I mostró mejoras subjetivas y objetivas estadísticamente significativas, transcurridos 3 y 6 meses. Además, la mejora de la prueba de Lysholm transcurridos 6 meses en el grupo II fue también estadísticamente significativa. Asimismo, los resultados de la prueba de Friedman para las variables VCOP y VY en el grupo I, con apoyo del lado lesionado en la placa de aplicación de fuerza, reflejaron una diferencia estadísticamente significativa en ambos períodos pre y postoperatorio transcurridos 3 meses, en comparación con el período postoperatorio transcurridos 6 meses. Las variables EAC y VX fueron estadísticamente diferentes para el grupo II, considerando el periodo preoperatorio, y los 3 y 6 meses postoperatorios.ConclusiónPreservar el remanente del LCA en los pacientes con lesiones en dicho ligamento tiene un impacto positivo en la estabilidad postural durante la recuperación.(AU)


Assuntos
Humanos , Ligamento Cruzado Anterior , Ferimentos e Lesões , Reconstrução Pós-Desastre , Cirurgia Geral , Joelho
2.
J Pak Med Assoc ; 74(4 (Supple-4)): S85-S89, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38712414

RESUMO

The Operating Room Black Box (ORBB) is a relatively recent technology that provides a comprehensive solution for assessing technical and non-technical skills of the operating team. Originating from aviation, the ORBB enables real-time observation and continuous recording of intraoperative events allowing for an in-depth analysis of efficiency, safety, and adverse events. Its dual role as a teaching tool enhances transparency and patient safety in surgical training. In comparison to traditional methods, like checklists that have limitations, the ORBB offers a holistic understanding of clinical and non-clinical performances that are responsible for intraoperative patient outcomes. It facilitates systematic observation without additional personnel, allowing for review of numerous surgical cases. This review highlights the potential benefits of the ORBB in enhancing patient safety, its role as a surgical training tool, and addresses barriers especially in resource-constrained settings. It signifies a transformative step towards global surgical practices, emphasizing transparency and improved surgical outcomes.


Assuntos
Salas Cirúrgicas , Segurança do Paciente , Humanos , Salas Cirúrgicas/normas , Lista de Checagem , Competência Clínica , Cirurgia Geral/educação
3.
J Robot Surg ; 18(1): 211, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38727932

RESUMO

Lack of formal national robotic curriculum results in a void of knowledge regarding appropriate progression of autonomy in robotic general surgery training. One midwestern academic surgical training program has demonstrated that residents expect to independently operate more on the robotic console than they perceive themselves to do. As such, our study sought to evaluate expectations of residents and faculty regarding resident participation versus actual console participation time (CPT) at a community general surgery training program. We surveyed residents and faculty in two phases. Initially, participants were asked to reflect on their perceptions and expectations from the previous six months. The second phase included surveys (collected over six months) after individual cases with subjective estimation of participation versus CPT calculated by the Intuitive Surgical, Inc. MyIntuitive application. Using Mann-Whitney U-Test, we compared resident perceptions of CPT to actual CPT by case complexity and post-graduate year (PGY). Faculty (n = 7) estimated they allowed residents to complete a median of 26-50% of simple and 0-25% of complex cases in the six months prior to the study. They expected senior residents (PGY-4 and PGY-5) to complete more: 51-75% of simple and 26-50% of complex cases. Residents (n = 13), PGY-2-PGY-5, estimated they completed less than faculty perceived (0-25% of simple and 0-25% of complex cases). Sixty-six post-case (after partial colectomy, abdominoperoneal resection, low anterior resection, cholecystectomy, inguinal/ventral hernia repair, and others) surveys were completed. Residents estimated after any case that they had completed 26-50% of the case. However, once examining their MyIntuitive report, they actually completed 51-75% of the case (median). Residents, especially PGY-4 and 5, completed a higher percentage than estimated of robotic cases. Our study confirms that residents can and should complete more of (and increasingly complex) robotic cases throughout training, like the transition of autonomy in open and laparoscopic surgery.


Assuntos
Competência Clínica , Cirurgia Geral , Internato e Residência , Procedimentos Cirúrgicos Robóticos , Procedimentos Cirúrgicos Robóticos/educação , Humanos , Cirurgia Geral/educação , Inquéritos e Questionários , Fatores de Tempo
4.
BMC Med Educ ; 24(1): 518, 2024 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-38730375

RESUMO

PURPOSE: Satisfaction should be prioritized to maximize the value of education for trainees. This study was conducted with professors, fellows, and surgical residents in the Department of general surgery (GS) to evaluate the importance of various educational modules to surgical residents. METHODS: A questionnaire was administered to professors (n = 28), fellows (n = 8), and surgical residents (n = 14), and the responses of the three groups were compared. Four different categories of educational curricula were considered: instructor-led training, clinical education, self-paced learning, and hands-on training. RESULTS: The majority of surgeons regarded attending scrubs as the most important educational module in the training of surgical residents. However, while professors identified assisting operators by participating in surgery as the most important, residents assessed the laparoscopic training module with animal models as the most beneficial. CONCLUSIONS: The best educational training course for surgical residents was hands-on training, which would provide them with several opportunities to operate and perform surgical procedures themselves.


Assuntos
Currículo , Cirurgia Geral , Internato e Residência , Humanos , Cirurgia Geral/educação , Inquéritos e Questionários , Cirurgiões/educação , Masculino , Feminino , Atitude do Pessoal de Saúde , Educação de Pós-Graduação em Medicina , Docentes de Medicina , Competência Clínica
5.
J Surg Educ ; 81(6): 776-779, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38692984

RESUMO

OBJECTIVE: Effective mentorship plays a crucial role in the professional development of surgical residents by providing guidance, support, networking, and facilitating personal, and career growth. This is particularly significant for female and underrepresented minority residents who often encounter additional challenges due to discrimination and historical lack of representation. Our objective is to present a framework for structuring a progressive and inclusive formal mentorship program- Surgery IMPACT- which embodies a panoramic perspective of surgery residency. DESIGN: A holistic mentorship program was created through the conceptualization of WISE Domains (Work-Life Balance, Interpersonal and cultural proficiency, Scholarly and career advancement, Effective learning and study techniques). Mentor-Mentee partnerships were created between current surgical faculty and general surgery residents. The foundation of the program is built upon four essential mentor roles: Core faculty mentor, research mentor, fellowship mentor, alongside a concurrent incorporation of peer mentorship. Over the academic year, we encouraged at least 3 formal mentorship meeting prefaced by a reflective exercise by the residents. CONCLUSIONS: The implementation of Surgery IMPACT has been successful in formalizing mentorship opportunities at our institution. By incorporating WISE domains, structured meeting centered on well-defined objectives, we have effectively created an all-inclusive mentorship program to foster resident growth and equal opportunities. Our ongoing commitment is to further refine and expand this innovative program with the aspiration of galvanizing similar mentorship models across diverse surgical programs.


Assuntos
Cirurgia Geral , Internato e Residência , Mentores , Cirurgia Geral/educação , Humanos , Feminino , Tutoria/organização & administração , Educação de Pós-Graduação em Medicina/métodos , Masculino
8.
Can J Surg ; 67(3): E216-E227, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38729642

RESUMO

SummaryIn 1923, just over 100 years ago, Edward William Archibald was appointed the first chair of surgery in McGill University's Faculty of Medicine. This milestone provides an opportunity to reflect on where the department has come from and how it has progressed to the present day. Although the size, breadth, and diversity of the department members have changed notably over the century, the core values of innovative clinical care, research, and education established a century ago continue to this day. To reflect his values, the Archibald Chair of Surgery was established in 1990 and is today held by the department chair.


Assuntos
Cirurgia Geral , História do Século XX , História do Século XXI , Cirurgia Geral/história , Quebeque , Humanos , Centro Cirúrgico Hospitalar/história , Centro Cirúrgico Hospitalar/organização & administração
11.
Anaesthesiologie ; 73(5): 294-323, 2024 May.
Artigo em Alemão | MEDLINE | ID: mdl-38700730

RESUMO

The 70 recommendations summarize the current status of preoperative risk evaluation of adult patients prior to elective non-cardiothoracic surgery. Based on the joint publications of the German scientific societies for anesthesiology and intensive care medicine (DGAI), surgery (DGCH), and internal medicine (DGIM), which were first published in 2010 and updated in 2017, as well as the European guideline on preoperative cardiac risk evaluation published in 2022, a comprehensive re-evaluation of the recommendation takes place, taking into account new findings, the current literature, and current guidelines of international professional societies. The revised multidisciplinary recommendation is intended to facilitate a structured and common approach to the preoperative evaluation of patients. The aim is to ensure individualized preparation for the patient prior to surgery and thus to increase patient safety. Taking into account intervention- and patient-specific factors, which are indispensable in the preoperative risk evaluation, the perioperative risk for the patient should be minimized and safety increased. The recommendations for action are summarized under "General Principles (A)," "Advanced Diagnostics (B)," and the "Preoperative Management of Continuous Medication (C)." For the first time, a rating of the individual measures with regard to their clinical relevance has been given in the present recommendation. A joint and transparent agreement is intended to ensure a high level of patient orientation while avoiding unnecessary preliminary examinations, to shorten preoperative examination procedures, and ultimately to save costs. The joint recommendation of DGAI, DGCH and DGIM reflects the current state of knowledge as well as the opinion of experts. The recommendation does not replace the individualized decision between patient and physician about the best preoperative strategy and treatment.


Assuntos
Anestesiologia , Cuidados Críticos , Procedimentos Cirúrgicos Eletivos , Cuidados Pré-Operatórios , Humanos , Cuidados Pré-Operatórios/normas , Cuidados Pré-Operatórios/métodos , Procedimentos Cirúrgicos Eletivos/normas , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Adulto , Anestesiologia/normas , Alemanha , Cuidados Críticos/normas , Medicina Interna/normas , Medição de Risco , Sociedades Médicas , Cirurgia Geral/normas
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