Abstract：
BACKGROUND:Numerous protocols for laparoscopic skills training using simulator-based laboratories have proven effective. However, little is known about the availability and uniformity of such facilities. The purpose of this study was to evaluate the prevalence, utilization, and costs of skills laboratories currently in use. METHODS:A survey was mailed to 253 general surgery program directors to determine the perceived value, prevalence, equipment, types of training, supervision, and costs of the labs. RESULTS:One hundred sixty-two (64%) programs completed the survey. Eighty-eight percent of responders consider skills labs effective in improving operating room performance; however, only 55% have skills labs. Of 89 programs with skills labs, 99% have videotrainer equipment (mean 3.8 trainers per lab, range 1 to 15); 46% have virtual reality trainer equipment (mean 1.7 trainers per lab, range 1 to 7). Eighty-two percent of programs teach basic skills using a variety of tasks (Rosser/Southwestern stations, MIST-VR, MISTELS, department-created); 96% teach suturing (intracorporeal, extracorporeal, suture devices). On average, residents train 0.8 hours per week (range 0 to 6). Training is mandatory in 55% and supervised in 73% of the programs. The mean development cost was 133,000 dollars (range 300 dollars to 1,000,000 dollars). CONCLUSIONS:While a large majority of program directors consider skills labs important, 45% of programs have no such facilities. Moreover, significant variability of equipment and training practices exist in currently available labs. Strategies are needed for more widespread implementation of skills labs, and standards should be developed to facilitate uniform adoption of validated curricula that reliably maximize training efficiency and educational benefit.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Korndorffer JR Jr,Stefanidis D,Scott DJdoi
10.1016/j.amjsurg.2005.05.048subject
Has Abstractpub_date
2006-01-01 00:00:00pages
17-22issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(05)00608-2journal_volume
191pub_type
杂志文章,多中心研究abstract：:With the aid of ultrasonography, representative percutaneous biopsy specimens were obtained from 20 of 21 patients (95 percent) with liver metastases of carcinoids and endocrine pancreatic tumors. The specimens were examined with silver stains and immunocytochemically after the application of monoclonal serotonin anti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90470-7
更新日期：1984-09-01 00:00:00
abstract：:An analysis of unsuccessful extractions of retained biliary calculi using basket catheters reveals more than half the failures are related to the selection, placement, and size of the T tube. A new T tube has been developed which will improve postoperative access to the common duct and facilitate removal of retained c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(78)90164-2
更新日期：1978-06-01 00:00:00
abstract：BACKGROUND:The biofragmentable anastomosis ring (BAR) was introduced by Hardy in 1985 as a simple alternative to sutured or stapled intestinal anastomosis. METHODS:The aim of this study was to analyze complications related to the use of the BAR in elective intraperitoneal intestinal anastomosis to identify technical a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.01.005
更新日期：2006-04-01 00:00:00
abstract：:Blunt trauma to the neck requires a systematic analysis of the laryngotrachea, the esophagus and the cervical spine in addition to general trauma considerations. Acute airway decompensation is best managed by tracheotomy, although if the situation permits, an orderly physical examination including indirect laryngoscop...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90132-x
更新日期：1981-04-01 00:00:00
abstract：BACKGROUND:The aim of this study was to evaluate the incidence of severe complications of adult inguinal hernia surgery from 2003 to 2007 using data from the Finnish National Patient Insurance Association. METHODS:All major surgical complications are reported to the association because it handles financial compensatio...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.04.018
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:The aim of this study is to establish a relationship between critical ischemia of the lower limb and kidney dysfunction. MATERIALS AND METHODS:At rest, urine samples were collected from three groups: group A, 16 patients with critical ischemia; group B, 22 patients with stable intermittent claudication; and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01406-x
更新日期：2003-04-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to determine the indications and outcome of surgery in patients with Hashimoto's thyroiditis (HT). METHODS:All patients who underwent thyroidectomy from 1990 to 2009 with pathologically confirmed HT were identified. Patients whose principle diagnosis was HT were evaluated for s...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.08.021
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:This study characterizes the gastrointestinal (GI) microbiome in a pre-clinical polytrauma hemorrhage model. METHODS:Rats (n = 6) were anesthetized, hemorrhaged 20% of their blood volume, and subjected to a femur fracture and crush injuries to the small intestine, liver, and limb skeletal muscle without res...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.026
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Factors that determine recurrence and complications following primary tissue repair of umbilical hernias (UHs) and the approach to repair UHs in obese patients need further analysis. METHODS:A retrospective review of UH repair (UHR) conducted at our institution was undertaken. Patients were grouped by body ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.03.014
更新日期：2016-01-01 00:00:00
abstract：:The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90412-3
更新日期：1982-10-01 00:00:00
abstract：BACKGROUND:Traumatic vascular injuries are infrequent but can be devastating. This study characterized their incidence and the need for vascular surgeons in their repair. Outcomes for patients repaired by vascular and trauma surgeons were compared. METHODS:Patients age ≥14, needing operations for acute traumatic vascu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.11.011
更新日期：2016-03-01 00:00:00
abstract：:The use of percutaneous transluminal angioplasty as the primary treatment of renovascular stenosis in adults has recently been described. Previously, only three children have been reported to have undergone transluminal angioplasty for stenosis of the renal artery and hypertension. At our hospital, transluminal angiop...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90114-9
更新日期：1983-05-01 00:00:00
abstract：:Rectal prolapse that is intractable to the usual medical therapy was successfully managed without significant complications in 10 patients by simple subcutaneous encirclement of the anus with a heavy nonabsorbable suture, which was in place until the suture was removed or broke after 4 to 6 months. Four patients requi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)81022-0
更新日期：1990-11-01 00:00:00
abstract：BACKGROUND:Efforts to improve surgical safety are limited by several factors and no consensus exists regarding the most effective way to improve surgical quality. The use of ISO 9001 quality standards within healthcare is recognized but has not been widely applied for improving surgical outcomes. METHODS:A surgical qu...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.11.014
更新日期：2020-11-09 00:00:00
abstract：:Gastric emptying was delayed preoperatively in 9 of 19 patients with duodenal ulcer disease, but all 9 patients with evidence of retention by scan were asymptomatic; gastric emptying was normal in the remaining 10 patients. A significant delay in gastric emptying was documented by scan in 17 of 19 patients immediately...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90134-9
更新日期：1982-01-01 00:00:00
abstract：:A prospective study of 390 indwelling central venous catheters placed by way of the subclavian route identified bacteremia and tracheostomy as the only significant variables associated with the colonization of the catheters by pathogenic microorganisms. Catheter-related sepsis was likely in only 3 of 33 episodes of pr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90085-0
更新日期：1979-06-01 00:00:00
abstract：:Despite immediate operation, patients with abdominal aortic injuries and profound hypovolemic shock do not respond to the usual methods of resuscitation and die soon after celiotomy, prior to control and repair of the aortic injury. The rate of aortic hemorrhage exceeds the ability to restore blood volume. Shock becom...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90385-4
更新日期：1979-08-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to investigate the reliability and validity of a performance assessment of communication, professionalism, and surgical skills competencies for surgery residents. METHODS:Fourteen residents from the general surgery program of the University of Calgary were assessed in 7 surgica...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.07.045
更新日期：2011-10-01 00:00:00
abstract：:Aortobrachiocephalic reconstruction was studied in 26 patients. Nine had suffered a previous stroke, and seven had residual deficity. A previous carotid endarterectomy or carotid-to-subclavian bypass had been performed in eight patients. The ascending aorta was the proximal anastomotic site in all cases. Bypass grafti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80364-7
更新日期：1988-08-01 00:00:00
abstract：BACKGROUND:Accuracy of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) and contribution to surgical decision making in recurrent or metastatic colorectal cancer were evaluated. METHODS:One hundred whole-body PET tests in colorectal cancer patients (1994 to 1998) were compared with computed tomography (...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(00)00406-2
更新日期：2000-07-01 00:00:00
abstract：BACKGROUND:In recent years, increasingly accessible and novel genetic technologies have spurred keen interest in the application of cancer genetics in predicting prognosis and response to treatment. In particular, investigators have eagerly sought to establish and validate genetic signatures that might improve the iden...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2016.06.019
更新日期：2016-10-01 00:00:00
abstract：BACKGROUND:The Centers for Disease Control and Prevention reported that surgical site infections (SSIs) create a significant hospital burden. To date, few multi-institutional studies have been performed to evaluate the risk factors for SSIs in mastectomy patients. METHODS:By using the American College of Surgeons' Nat...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.05.007
更新日期：2013-02-01 00:00:00
abstract：:Over the last decade, significant technological advancements have occurred in cardiac surgery. One such breakthrough has been the use of robotic telemanipulation systems, which allow the surgeon to perform cardiac surgery through a minimally invasive approach. As a result, surgery for atrial fibrillation and resynchro...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2004.08.001
更新日期：2004-10-01 00:00:00
abstract：BACKGROUND:This study defines the clinical settings in which extended radical neck dissection (ERND) was performed and determines its impact on control of disease in the neck and on survival. METHODS:We reviewed the records of 106 patients undergoing ERND between 1984 and 1993. Most (76) had metastatic squamous cell c...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00163-3
更新日期：1997-11-01 00:00:00
abstract：BACKGROUND:Surgery is an environment in which being an expert requires the ability to manage the unexpected. This feature has necessitated a shift in surgical decision-making research. The present study explores the processes by which surgeons assess and respond to nonroutine challenges in the operating room. METHODS:...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.10.005
更新日期：2013-02-01 00:00:00
abstract：BACKGROUND:Trauma readmissions have been well studied but little data exists regarding Emergency Department (ED) utilization following an injury. This study was performed to determine the factors associated with a return to the ED after trauma. METHODS:A retrospective review of all adult trauma patients evaluated betw...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.10.046
更新日期：2020-07-01 00:00:00
abstract：:From 1980 to 1984, 500 asymptomatic patients with anterior abdominal stab wounds found to have penetrated the anterior peritoneal cavity on local wound exploration in the emergency center were evaluated by the technique of open peritoneal tap, quantitative diagnostic peritoneal lavage, or both. The technique was found...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90435-5
更新日期：1984-12-01 00:00:00
abstract：BACKGROUND:Incision and drainage of perianal sepsis has appreciable success in the immunocompetent population, but outcomes after incision and drainage in the immunosuppressed population are unknown. METHODS:13,666 patients (n = 930 immunosuppressed) undergoing incision and drainage of perianal sepsis between 2011 and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.01.036
更新日期：2019-09-01 00:00:00
abstract：:A prospective clinical trial was designed to evaluate the efficacy of postoperative jejunostomy feedings using high (44 percent) and low (15 percent) branched-chain amino acid elemental diet formulations compared with no jejunostomy feedings in a homogeneous surgical population. Twenty-eight patients undergoing radica...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/0002-9610(87)90815-4
更新日期：1987-02-01 00:00:00
abstract：BACKGROUND:Surgical safety and quality initiatives have now moved to the front of the agenda for contemporary surgery. METHODS:Sixty-two surgical specialists began to study quality and cost control in 1998, and those efforts grew into a Centers for Medicare and Medicaid Services-funded pilot study of the Surgical Care...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.04.005
更新日期：2010-07-01 00:00:00
