Abstract：
BACKGROUND:On surgical simulators, measures of economy of hand motion have been shown to be reliable, valid, and objective measures of technical competence. Our goal was to validate hand-motion analysis (HMA) as an objective measure of surgical skill on real patients. METHODS:HMA (hand movement frequency, hand travel distance) was evaluated serially on 2 standardized, live patient surgeries (vasectomy, vasectomy reversal) for both a novice and experienced surgeon. HMA parameters were correlated with blinded, case-matched assessments of technical skill using previously validated global rating scales and surgical checklist scores applied to unedited surgical videos. Serial hand-motion data from the novice and experienced surgeon were plotted to establish competency-based learning curves over time. RESULTS:Intraoperative HMA correlated significantly with case-matched global rating and checklist scores. Meaningful improvements in the number of hand movements and hand travel distance were shown over time for the novice surgeon, but remained stable for the experienced surgeon. CONCLUSIONS:Intraoperative assessment of economy of hand motion represents a feasible, objective, and valid measure of technical skill and can be used to establish competency-based surgical learning curves.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Grober ED,Roberts M,Shin EJ,Mahdi M,Bacal Vdoi
10.1016/j.amjsurg.2009.07.033subject
Has Abstractpub_date
2010-01-01 00:00:00pages
81-5issue
1eissn
0002-9610issn
1879-1883pii
S0002-9610(09)00575-3journal_volume
199pub_type
杂志文章abstract：BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.11.019
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:We evaluated the effect of neoadjuvant therapy (NAT) on lymph node harvest in rectal cancer patients undergoing anatomic resection with curative intent. METHODS:A prospectively maintained database was retrospectively queried for rectal cancer cases from 1990 to 2010. Demographic data, NAT, and lymph node yi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.10.020
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:C-reactive protein (CRP) is a product synthesized in hepatocytes and has been reported to be upregulated by such proinflammatory cytokines as interleukin-1, interleukin-6, and tumor necrosis factor. The significance of a preoperative serum elevation in CRP as a predictive indicator for the malignant potentia...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00204-9
更新日期：1998-10-01 00:00:00
abstract：BACKGROUND:Chronic pain is a severe complication of mesh-based inguinal hernia repair. Its perceived risk varies widely in the literature. The current objectives are to review the incidence, severity, and consequences of chronic pain and its etiologies. DATA SOURCES:A multi-database systematic search was conducted for...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2007.02.012
更新日期：2007-09-01 00:00:00
abstract：BACKGROUND:HIV and AIDS continues to be a significant health problem with many patients requiring the attention of a general surgeon. METHOD:A retrospective case note review over a two-year period was undertaken. RESULTS:237 patients underwent invasive procedures. The majority 100 patients (145 procedures) were for v...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00054-2
更新日期：1996-07-01 00:00:00
abstract：PURPOSE:Stoma closure has been associated with a high rate of surgical site infection (SSI) and the optimal skin closure method is still controversial. The aim of this study was to compare the short-term and long-term outcomes between the conventional linear closure (CC) and the persestring closure (PC) using propensit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.09.031
更新日期：2018-01-01 00:00:00
abstract：:The type of endorectal pull-through described by Black was evaluated as an alternative method of anastomosis in 11 anterior resections in which anastomosis from above was impossible. The method is attractive from the standpoint of function because it preserves the distal rectum and leaves the anus intact. Technical po...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90249-6
更新日期：1979-07-01 00:00:00
abstract：:The success of parathyroid surgery is based on accurate localization of normal and abnormal parathyroid glands, knowledge of the pathologic conditions, and meticulous dissection during removal of the abnormal glands. Although parathyroid localization is essential in cases requiring re-exploration, there is considerabl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80976-6
更新日期：1993-09-01 00:00:00
abstract：:The insertion of pancreaticobiliary drains at the time of endoscopic retrograde cholangiopancreatography can provide access to the bile or pancreatic duct, decompress an obstructed biliary tree, and allow infusion of solubilizing agents to effect gallstone dissolution. Twenty-six patients underwent 32 attempts at drai...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90384-7
更新日期：1983-08-01 00:00:00
abstract：BACKGROUND:Chest wall recurrence (CWR) in the setting of previous mastectomy and breast reconstruction can pose complex management dilemmas for clinicians. We examined the impact of breast reconstruction on the treatment and outcomes of patients who subsequently developed a CWR. METHODS:Between 1988 and 1998, 155 brea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.11.006
更新日期：2004-02-01 00:00:00
abstract：BACKGROUND:Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS:A prospective FDA feasibilit...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.amjsurg.2017.10.054
更新日期：2018-03-01 00:00:00
abstract：:The role and effectiveness of intraoperative enteroscopy in the evaluation of gastrointestinal (GI) bleeding of obscure origin is not clearly defined. Our aim was to determine if intraoperative enteroscopy is effective in identifying a source, which would lead to therapy and prevent recurrent gastrointestinal hemorrha...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(92)90259-t
更新日期：1992-01-01 00:00:00
abstract：:A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80267-8
更新日期：1988-01-01 00:00:00
abstract：:Fifty-six patients undergoing elective colonic resection were prospectively randomized into two groups either with or without postoperative nasogastric decompression. The results demonstrated only minimal differences between the two groups. Postoperative abdominal distention was more common in patients without nasogas...
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)90233-9
更新日期：1987-12-01 00:00:00
abstract：:Three distinct forms of postoperative breakdown after Nissen fundoplication have been discussed. Disruption and recurrent reflux is most common, with slipping occurring infrequently. For the first time, three patients developing a proximal gastric pouch deformity causing partial obstruction of the fundus without recur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90278-1
更新日期：1977-07-01 00:00:00
abstract：:Specific circulating serum proteins may reflect unique properties governing the growth and progression of head and neck cancers. One hundred three previously untreated patients with squamous cell carcinoma of the head and neck were prospectively evaluated for serum IgA, IgG, and IgM and C1q-binding macromolecules. Imm...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80560-4
更新日期：1990-10-01 00:00:00
abstract：BACKGROUND:Surgery is considered the treatment of choice for postoperative biliary strictures. Recently, endoscopic stent placement has been proposed as an alternative to surgical management in selected patients. METHODS:In this retrospective study, 157 patients with postoperative biliary strictures were included. Eig...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(03)00082-5
更新日期：2003-06-01 00:00:00
abstract：:An adaptable on-line computer system for entry, retrieval, and analysis of medical discharge summaries has been developed and applied in the Trauma Service of a busy city hospital. Each summary occupied 5 to 10 minutes of the physician's time and compared favorably in cost to the standard dictated summary. While the a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90049-0
更新日期：1976-08-01 00:00:00
abstract：BACKGROUND:Glass tables can break and cause traumatic injury. This public health issue is avoidable by adequate regulatory measures. We describe the burden and characteristics of these injuries using the National Electronic Injury Surveillance System (NEISS) database and data from a level 1 trauma center. METHODS:NEIS...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.07.002
更新日期：2020-11-01 00:00:00
abstract：:In an effort to determine the current incidence and clinical course of Buerger's disease, we reviewed the records of over 700 patients with small artery disease who were evaluated at Oregon Health Sciences University during a 15 year period. We identified 26 patients who met rigid criteria for the diagnosis of Buerger...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90301-1
更新日期：1987-07-01 00:00:00
abstract：BACKGROUND:Following appendectomy, management is often guided by surgeon determination of whether the appendicitis is uncomplicated or complicated. Our objectives were to determine the incidence of discordance between intraoperative and pathological findings and determine effect on outcomes. METHODS:We performed a ret...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.05.004
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Although 90% of patients with neurogenic thoracic outlet syndrome (NTOS) experience "excellent" or "good" results after thoracic outlet decompression, recurrent symptoms may develop in certain patients. METHODS:This is a retrospective review of patients with NTOS who developed recurrent symptoms of upper ex...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.050
更新日期：2004-04-01 00:00:00
abstract：BACKGROUND:The aims of this study were to compare the effectiveness of percutaneous drainage between pyogenic hepatic abscesses with and those without biliary communication and to evaluate the role of endoscopic biliary stent placement in the treatment of communicating abscesses. METHODS:Sixty-one patients with hepati...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(01)00869-8
更新日期：2002-02-01 00:00:00
abstract：:Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail. Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis. System...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90397-0
更新日期：1979-08-01 00:00:00
abstract：:Forty-two patients (age range: 70 to 86 years) underwent pancreaticoduodenectomy between 1970 and 1990 for carcinomas of the pancreas (23), ampulla (8), common bile duct (5), duodenum (5), or islet cells (1). After resection, reconstruction was done by either pancreaticojejunostomy (13) or pancreaticogastrostomy (25);...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90104-l
更新日期：1991-12-01 00:00:00
abstract：:Our experience from 1960 to 1976 with total infrarenal aortic thrombosis (Leriche syndrome) was reviewed. Sixteen heavy smokers (14 men and 2 women) with an average age of fifty-four years underwent thrombectomy with aortoiliac (12 patients) or aortofemoral (4) Dacron bypasses. The last ten patients were hydrated for ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90331-2
更新日期：1977-12-01 00:00:00
abstract：BACKGROUND:The pathophysiology of adrenal insufficiency, common in surgical intensive care units, has not been fully elucidated. METHODS:Patients at risk (age > 55 years, in the surgical intensive care unit >1 week, baseline cortisol < 20 μg/dL) were enrolled. After measuring cortisol and adrenocorticotropic hormone (...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.11.015
更新日期：2012-02-01 00:00:00
abstract：:Sequential intraarterial chemotherapy using bleomycin and methotrexate followed by high dose radiation and surgery was evaluated in 10 patients with stage III and IV squamous carcinomas of the maxillary sinus. Seven of 10 patients had extensive tumor necrosis in the surgical specimen, and no evidence of residual tumor...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90037-4
更新日期：1981-05-01 00:00:00
abstract：BACKGROUND:Letters of recommendation (LoR) are considered one of the most important predictors of matching into a pediatric surgery fellowship. We determined if gendered differences exist in LoR written for resident candidates. METHODS:A retrospective review of blinded LoR to a fellowship program between 2015 and 2017...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.08.005
更新日期：2020-06-01 00:00:00
abstract：:Examples of the use of endoscopic pancreatography in the preoperative evaluation and postoperative follow-up study of patients with pancreatic disease are presented and discussed. Six cases selected from a total experience of forty-eight patients have been summarized. The direct role of pancreatography in the manageme...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(75)90164-6
更新日期：1975-01-01 00:00:00
