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  1. Article ; Online: Is dexmedetomidine the agent of choice in the resection of pheochromocytoma?

    Polavarapu, Harsha V / Kurian, Ashwin A / Josloff, Robert

    The American surgeon

    2012  Volume 78, Issue 3, Page(s) E127–8

    MeSH term(s) Adrenal Gland Neoplasms/drug therapy ; Adrenal Gland Neoplasms/surgery ; Adrenergic alpha-2 Receptor Agonists/administration & dosage ; Analgesics, Non-Narcotic/administration & dosage ; Blood Pressure/drug effects ; Dexmedetomidine/administration & dosage ; Female ; Humans ; Intraoperative Care ; Laparoscopy ; Laryngoscopy ; Middle Aged ; Phenoxybenzamine/administration & dosage ; Pheochromocytoma/drug therapy ; Pheochromocytoma/surgery ; Premedication
    Chemical Substances Adrenergic alpha-2 Receptor Agonists ; Analgesics, Non-Narcotic ; Phenoxybenzamine (0TTZ664R7Z) ; Dexmedetomidine (67VB76HONO)
    Language English
    Publishing date 2012-03
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Spigelian hernia, diagnosis, and minimally invasive repair: a case series of 11 patients.

    Sucandy, Iswanto / Miles, Melissa / Gallagher, Sidhbh / Josloff, Robert K

    The American surgeon

    2013  Volume 79, Issue 8, Page(s) E284–5

    MeSH term(s) Adult ; Aged ; Female ; Hernia, Ventral/diagnosis ; Hernia, Ventral/surgery ; Herniorrhaphy/instrumentation ; Herniorrhaphy/methods ; Humans ; Laparoscopy/instrumentation ; Laparoscopy/methods ; Male ; Middle Aged ; Retrospective Studies ; Surgical Mesh ; Treatment Outcome
    Language English
    Publishing date 2013-08
    Publishing country United States
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
    ISSN 0003-1348
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  3. Article ; Online: Predictors of in-hospital length of stay after laparoscopic ventral hernia repair: results of multivariate logistic regression analysis.

    Kurian, Ashwin / Gallagher, Sidhbh / Cheeyandira, Abhiman / Josloff, Robert

    Surgical endoscopy

    2010  Volume 24, Issue 11, Page(s) 2789–2792

    Abstract: Aim: To identify variables that predict in-hospital length of stay (LOS) after laparoscopic ventral hernia repair (LVHR).: Methods: Univariate analysis of patient and intraoperative variables was conducted on an operating room database of LVHRs ... ...

    Abstract Aim: To identify variables that predict in-hospital length of stay (LOS) after laparoscopic ventral hernia repair (LVHR).
    Methods: Univariate analysis of patient and intraoperative variables was conducted on an operating room database of LVHRs performed from April 2001 to April 2009. Analysis was performed using either chi-square or linear trend analysis, as appropriate. A multivariate logistic regression model was created manually, to determine independent variables that predict LOS. p Value <0.05 was considered significant.
    Results: A total of 221 patients, with mean age of 56 years (range 25-88 years) underwent LVHR, for a total of 121 incisional and 100 primary ventral hernias. Of patients, 40% had incarcerated hernias and 25% had complex hernias (defined as multiple points of weakness on the anterior abdominal wall). The overall conversion rate to open operation was 6%. Mean LOS was 1.54 days (range 0-22 days). Eighty-six patients (39%) were discharged on the day of the procedure. Variables associated with significantly longer LOS on univariate analysis were incisional hernia (p = 0.000009), mesh size (p = 0.00007), complex hernia (p = 0.00009), incarcerated hernia (p = 0.0004), patient age (p = 0.0006), need for lysis of adhesions (p = 0.001), and female gender (p = 0.01). American Society of Anesthesiologists (ASA) grade >2, conversion to open procedure, and recurrent hernia were not associated with longer LOS. Four factors were independently associated with significant longer length of stay on multivariate logistic regression analysis (p < 0.05): mesh size (p = 0.00005), incarcerated hernia (p = 0.002), patient age (p = 0.018), and complex hernia (p = 0.035).
    Conclusions: Mesh size, incarcerated hernia, patient age, and complex hernia predict longer length of stay after laparoscopic ventral hernia repair.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Female ; Hernia, Ventral/pathology ; Hernia, Ventral/surgery ; Humans ; Laparoscopy/methods ; Length of Stay ; Male ; Middle Aged ; Postoperative Complications ; Surgical Mesh
    Language English
    Publishing date 2010-04-24
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-010-1048-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Resident Operative Experience at Independent Academic Medical Centers-A Comparison to the National Cohort.

    Joshi, Amit R T / Trickey, Amber W / Jarman, Benjamin T / Kallies, Kara J / Josloff, Robert / Dort, Jonathan M / Kothuru, Ravi

    Journal of surgical education

    2017  Volume 74, Issue 6, Page(s) e88–e94

    Abstract: Purpose: Independent Academic Medical Centers (IAMCs) comprise one-third of U.S. general surgery training programs. It is unclear whether IAMCs offer qualitatively or quantitatively different operative experiences than the national cohort. We analyzed a ...

    Abstract Purpose: Independent Academic Medical Centers (IAMCs) comprise one-third of U.S. general surgery training programs. It is unclear whether IAMCs offer qualitatively or quantitatively different operative experiences than the national cohort. We analyzed a large representative sample of IAMCs to compare operative volume and variety, with a focus on low-volume procedures.
    Methods: Accreditation Council for Graduate Medical Education Program Case Reports from 27 IAMCs were collected and analyzed for 3 academic years (2012-2015). IAMCs were compared to the national cohort for specific defined category volumes and selected low-volume cases. One-sample two-way t-tests were calculated comparing IAMC totals to national program averages.
    Results: IAMCs had a median of 3 chief residents per year (range: 1-6). IAMCs reported significantly more "total major" procedures in 2013-2014 (p = 0.046). Other case totals were statistically similar between IAMCs and the national cohort for "total major", "surgeon chief", "surgeon junior", and "teaching assistant" cases. In 2013-2014, IAMCs reported more laparoscopic complex (138.3 vs. 110.6, p = 0.010) and alimentary tract cases (276.5 vs. 253.5, p = 0.019). IAMC esophagogastroduodenoscopy case totals were higher in 2013-2014 (55.9 vs. 41, p = 0.038) and 2014-2015 (47.8 vs. 41, p = 0.047). IAMCs had fewer pancreas cases than the national cohort in all three years by about three cases per resident (p ≤ 0.026). In 2012-2013 IAMCs reported fewer (by about one) esophagectomy, gastrectomy, and abdominal perineal resections. No differences were observed in the following selected procedures: open common bile duct exploration, inguinal hernia, laparoscopic appendectomy, laparoscopic cholecystectomy, and colonoscopy.
    Conclusions: The IAMCs studied appear to provide equivalent exposure to specific subcategories mandated by the Accreditation Council for Graduate Medical Education and American Board of Surgery. Graduates of IAMCs gain similar operative experience in low-volume, defined categories when compared to the national cohort. Certain specific cases subject to regionalization pressure are less well represented among IAMCs. This has important implications for medical students applying to surgery residency.
    MeSH term(s) Academic Medical Centers/organization & administration ; Accreditation ; Adult ; Clinical Competence ; Cohort Studies ; Education, Medical, Graduate/organization & administration ; Female ; General Surgery/education ; Humans ; Internship and Residency/organization & administration ; Laparoscopy/education ; Male ; Program Evaluation ; United States
    Language English
    Publishing date 2017-06-09
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2017.05.020
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Severe clostridium infection of liver metastases presenting as pneumoperitoneum.

    Sucandy, Iswanto / Gallagher, Sidhbh / Josloff, Robert K / Nussbaum, Michael L

    The American surgeon

    2012  Volume 78, Issue 7, Page(s) E338–9

    MeSH term(s) Adenocarcinoma/complications ; Adenocarcinoma/diagnosis ; Adenocarcinoma/secondary ; Aged ; Clostridium Infections/complications ; Clostridium Infections/diagnosis ; Clostridium septicum/isolation & purification ; Colonic Neoplasms/pathology ; Diagnosis, Differential ; Fatal Outcome ; Humans ; Intestinal Perforation/diagnosis ; Liver Abscess/complications ; Liver Abscess/diagnosis ; Liver Neoplasms/complications ; Liver Neoplasms/diagnosis ; Liver Neoplasms/secondary ; Male ; Pneumoperitoneum/diagnosis ; Pneumoperitoneum/etiology ; Rupture, Spontaneous/complications ; Rupture, Spontaneous/diagnosis
    Language English
    Publishing date 2012-07
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 202465-2
    ISSN 1555-9823 ; 0003-1348
    ISSN (online) 1555-9823
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  6. Article ; Online: Unusual complication: small bowel obstruction caused by tubing of gastric band.

    Strobos, Eben / Antanavicius, Gintaras / Josloff, Robert

    Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery

    2009  Volume 5, Issue 5, Page(s) 637–640

    MeSH term(s) Adult ; Foreign Bodies/complications ; Gastroplasty/adverse effects ; Gastroplasty/instrumentation ; Humans ; Intestinal Obstruction/etiology ; Intestinal Obstruction/surgery ; Intestine, Small ; Male ; Obesity, Morbid/surgery
    Language English
    Publishing date 2009-09
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2274243-8
    ISSN 1878-7533 ; 1550-7289
    ISSN (online) 1878-7533
    ISSN 1550-7289
    DOI 10.1016/j.soard.2009.04.013
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  7. Article: Littoral cell angioma of the spleen treated by laparoscopic splenectomy.

    Blansfield, Joseph A / Goldhahn, Richard T / Josloff, Robert K

    JSLS : Journal of the Society of Laparoendoscopic Surgeons

    2005  Volume 9, Issue 2, Page(s) 222–224

    Abstract: Massive splenomegaly due to multifocal littoral cell angioma was discovered incidentally in a 55-year-old man during a workup for an unrelated condition. The tumor was removed successfully by laparoscopic splenectomy. We report the second case of ... ...

    Abstract Massive splenomegaly due to multifocal littoral cell angioma was discovered incidentally in a 55-year-old man during a workup for an unrelated condition. The tumor was removed successfully by laparoscopic splenectomy. We report the second case of littoral cell angioma of the spleen treated laparoscopically.
    MeSH term(s) Hemangioma/diagnostic imaging ; Hemangioma/surgery ; Humans ; Incidental Findings ; Laparoscopy ; Male ; Middle Aged ; Splenectomy/methods ; Splenic Neoplasms/diagnostic imaging ; Splenic Neoplasms/surgery ; Tomography, X-Ray Computed
    Language English
    Publishing date 2005-03-21
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2011211-7
    ISSN 1938-3797 ; 1086-8089
    ISSN (online) 1938-3797
    ISSN 1086-8089
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    Zs.MO 310: Show issues

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  8. Article ; Online: A Multicenter Prospective Comparison of the Accreditation Council for Graduate Medical Education Milestones: Clinical Competency Committee vs. Resident Self-Assessment.

    Watson, Ryan S / Borgert, Andrew J / O Heron, Colette T / Kallies, Kara J / Sidwell, Richard A / Mellinger, John D / Joshi, Amit R / Galante, Joseph M / Chambers, Lowell W / Morris, Jon B / Josloff, Robert K / Melcher, Marc L / Fuhrman, George M / Terhune, Kyla P / Chang, Lily / Ferguson, Elizabeth M / Auyang, Edward D / Patel, Kevin R / Jarman, Benjamin T

    Journal of surgical education

    2017  Volume 74, Issue 6, Page(s) e8–e14

    Abstract: Objective: The Accreditation Council for Graduate Medical Education requires accredited residency programs to implement competency-based assessments of medical trainees based upon nationally established Milestones. Clinical competency committees (CCC) ... ...

    Abstract Objective: The Accreditation Council for Graduate Medical Education requires accredited residency programs to implement competency-based assessments of medical trainees based upon nationally established Milestones. Clinical competency committees (CCC) are required to prepare biannual reports using the Milestones and ensure reporting to the Accreditation Council for Graduate Medical Education. Previous research demonstrated a strong correlation between CCC and resident scores on the Milestones at 1 institution. We sought to evaluate a national sampling of general surgery residency programs and hypothesized that CCC and resident assessments are similar.
    Design: Details regarding the makeup and process of each CCC were obtained. Major disparities were defined as an absolute mean difference of ≥0.5 on the 4-point scale. A negative assessment disparity indicated that the residents evaluated themselves at a lower level than did the CCC. Statistical analysis included Wilcoxon rank sum and Sign tests.
    Setting: CCCs and categorical general surgery residents from 15 residency programs completed the Milestones document independently during the spring of 2016.
    Results: Overall, 334 residents were included; 44 (13%) and 43 (13%) residents scored themselves ≥0.5 points higher and lower than the CCC, respectively. Female residents scored themselves a mean of 0.08 points lower, and male residents scored themselves a mean of 0.03 points higher than the CCC. Median assessment differences for postgraduate year (PGY) 1-5 were 0.03 (range: -0.94 to 1.28), -0.11 (range: -1.22 to 1.22), -0.08 (range: -1.28 to 0.81), 0.02 (range: -0.91 to 1.00), and -0.19 (range: -1.16 to 0.50), respectively. Residents in university vs. independent programs had higher rates of negative assessment differences in medical knowledge (15% vs. 6%; P = 0.015), patient care (17% vs. 5%; P = 0.002), professionalism (23% vs. 14%; P = 0.013), and system-based practice (18% vs. 9%; P = 0.031) competencies. Major assessment disparities by sex or PGY were similar among individual competencies.
    Conclusions: Surgery residents in this national cohort demonstrated self-awareness when compared to assessments by their respective CCCs. This was independent of program type, sex, or level of training. PGY 5 residents, female residents, and those from university programs consistently rated themselves lower than the CCC, but these were not major disparities and the significance of this is unclear.
    MeSH term(s) Accreditation ; Advisory Committees ; Clinical Competence ; Cohort Studies ; Competency-Based Education ; Education, Medical, Graduate/methods ; Female ; General Surgery/education ; Humans ; Internship and Residency/methods ; Male ; Prospective Studies ; Self-Assessment ; United States
    Language English
    Publishing date 2017-06-27
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2017.06.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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