The validity of take-home surgical simulators to enhance resident technical skill proficiency.


BACKGROUND:It is unknown whether surgical residents who learn minimal-access surgery skills in an unstructured environment (ie, at home), will develop a technical skill set that rivals that of those trained in the more traditional, structured learning environment. METHODS:Seven surgery residents were provided structured learning through didactic and hands-on skills training sessions and consistent supervision throughout training. A second group of 7 residents participated in an unstructured learning curriculum of training without supervision. End points were determined at the end of training using a standardized simulator based on predetermined performance measures. RESULTS:Both groups achieved high task scores, with comparable scores on gesture proficiency, hand movement smoothness, instrument movement smoothness, errors, and time elapsed. There was no significant difference between group differences in final skills scores. CONCLUSIONS:Unstructured learning is equally effective in delivering quality skills training when compared with structured training.


Am J Surg


Uccelli J,Kahol K,Ashby A,Smith M,Ferrara J




Has Abstract


2011-03-01 00:00:00


315-9; discussion 319












  • Total infrarenal aortic occlusion.

    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


    authors: Casali RE,Tucker E,Read RC,Thompson BW

    更新日期:1977-12-01 00:00:00

  • Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: Safety, prognostic factors and oncologic outcome.

    abstract:BACKGROUND:To analyze our experience with laparoscopic right Mesocolectomy in right colonic cancers. METHODS:600 consecutive patients were studied. RESULTS:Mortality was 0.5%; morbidity was 35.5%. Mean mesocolic area was 15339 ± 1639 mm3, specimen length 24.3 ± 3.3 cm, distance from the tumor to high tie was 103 ± 6 ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Siani LM,Lucchi A,Berti P,Garulli G

    更新日期:2017-08-01 00:00:00

  • Disparities in access to cancer surgery after Medicaid expansion.

    abstract:INTRODUCTION:The Affordable Care Act (ACA) expanded Medicaid eligibility to persons with income up to 138% of the federal poverty line. We investigated how Medicaid expansion (ME) impacted the access to cancer-specific surgical care in the US. METHODS:We used a nationwide population-based database (SEER) to identify p...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Mesquita-Neto JWB,Cmorej P,Mouzaihem H,Weaver D,Kim S,Macedo FI

    更新日期:2020-01-01 00:00:00

  • Role of cortisol in the restitution of blood volume after hemorrhage.

    abstract::The restitution of blood volume and plasma protein after 10 per cent hemorrhage was studied in intact dogs and in dogs subjected to adrenalectomy and infused with cortisol at basal or physiologically increased rates. The results suggest that increased extracellular osmolality, mediated by an increased secretion of cor...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Gann DS,Pirkle JC Jr

    更新日期:1975-11-01 00:00:00

  • The fate of unscreened women in colon cancer: impact on staging and prognosis.

    abstract:BACKGROUND:Several nationwide reports show lower female participation in colon cancer screening. We therefore assessed for outcome differences in women of screening age presenting for surgical treatment of colon cancer patients. METHODS:All patients over 50 years undergoing surgery for first-onset colon cancer at Mass...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Amri R,Bordeianou LG,Sylla P,Berger DL

    更新日期:2015-06-01 00:00:00

  • Does delaying repair of an asymptomatic hernia have a penalty?

    abstract:BACKGROUND:The incidence of hernia accident for inguinal hernias in men who are minimally symptomatic is sufficiently low that watchful waiting is an acceptable alternative to routine repair. Our aim was to determine whether a delay in hernia surgery affects short- and long-term outcomes. METHODS:Patients from a multi...

    journal_title:American journal of surgery

    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Thompson JS,Gibbs JO,Reda DJ,McCarthy M Jr,Wei Y,Giobbie-Hurder A,Fitzgibbons RJ Jr

    更新日期:2008-01-01 00:00:00

  • Pneumomediastinum in blunt trauma: If aerodigestive injury is not seen on CT, invasive workup is not indicated.

    abstract:BACKGROUND:Pneumomediastinum following blunt trauma is often observed on CT imaging, and concern for associated aerodigestive injury often prompts endoscopy and/or fluoroscopy. In recent years, adoption of multi-detector CT technology has resulted in high resolution images that may clearly identify aerodigestive injuri...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Matthees NG,Mankin JA,Trahan AM,Israr S,Jones MD,Dameworth JL,Petersen SR,Weinberg JA

    更新日期:2019-06-01 00:00:00

  • Techniques of parathyroid exploration at North American endocrine surgery fellowship programs: what the next generation is being taught.

    abstract:BACKGROUND:Minimally invasive techniques are now often used to treat primary hyperparathyroidism but with uncertain conformity and some controversy. Endocrine surgery fellowships (ESFPs) have recently proliferated. METHODS:The directors of the 19 ESFPs recognized by the American Association of Endocrine Surgeons were ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Wang TS,Pasieka JL,Carty SE

    更新日期:2014-04-01 00:00:00

  • Congenital anomalies of the diaphragm. Personal experience with thirty-five consecutive cases.

    abstract::A personal experience of thirty-five consecutive patients with congenital anomalies of the diaphragm is reported. The anomalies included twenty-five Bochdalek hernias, seven diaphragmatic eventrations, and three esophageal hiatal hernias. Except for the patients with esophageal hiatal hernias, virtually all patients p...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Harberg FJ,Meagher D,Wetchler S,Harris F

    更新日期:1976-12-01 00:00:00

  • High-resolution computed tomography accurately predicts resectability in hilar cholangiocarcinoma.

    abstract:INTRODUCTION:Despite the use of radiologic, endoscopic, and laparoscopic staging techniques, the rate of nontherapeutic laparotomies in patients with hilar cholangiocarcinoma remains high. This study evaluated the accuracy of preoperative high-resolution computed tomography (HRCT) to determine resectability in this set...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Aloia TA,Charnsangavej C,Faria S,Ribero D,Abdalla EK,Vauthey JN,Curley SA

    更新日期:2007-06-01 00:00:00

  • Prevention of postoperative thrombosis by aspirin.

    abstract::In a random double-blind trial monitored by 125I-fibrinogen leg scan, impedance plethysmography, and contrast phleobograms if impedance became abnormal, hydroxycholoroquine was shown to be no more effective than placebo for prevention of venous thrombosis after total hip replacement. Subsequently, the combination of h...

    journal_title:American journal of surgery

    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Hume M,Bierbaum B,Kuriakose TX,Surprenant J

    更新日期:1977-04-01 00:00:00

  • Intramammary lymph nodes and breast cancer: a marker for disease severity, or just another lymph node?

    abstract:BACKGROUND:Axillary lymph node status is still considered the most significant prognostic factor for breast cancer outcome, and treatment decisions are based on the presence or absence of nodal disease. Intramammary lymph nodes (IMLNs) can be a site of regional spread. Is this a marker for more aggressive disease? MET...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Guth AA,Mercado C,Roses DF,Hiotis K,Skinner K,Diflo T,Cangiarella J

    更新日期:2006-10-01 00:00:00

  • The coming of age of our understanding of the enterohepatic circulation of bile salts.

    abstract::Recent advances in molecular biology have greatly accelerated knowledge relating to the significance of the enterohepatic circulation of bile salts. This review highlights the role that both oxysterols and bile salts play as ligands which, when bound to nuclear hormone receptors, activate transcription factors that se...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审


    authors: Redinger RN

    更新日期:2003-02-01 00:00:00

  • Easy insertion of a feeding tube.

    abstract::A small bore feeding tube may be readily introduced into the stomach by splinting it internally, before insertion, with a flexible arteriographic guide wire, which is removed when the tube is in place. Gentle placement of the tube is recommended. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Martin DC Jr

    更新日期:1980-05-01 00:00:00

  • A prospective randomized controlled trial to compare Pringle maneuver, hemihepatic vascular inflow occlusion, and main portal vein inflow occlusion in partial hepatectomy.

    abstract:BACKGROUND:blood loss during liver resection and the need for perioperative blood transfusions have negative impact on perioperative morbidity, mortality, and long-term outcomes. METHODS:a randomized controlled trial was performed on patients undergoing liver resection comparing hemihepatic vascular inflow occlusion, ...

    journal_title:American journal of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Fu SY,Lau WY,Li GG,Tang QH,Li AJ,Pan ZY,Huang G,Yin L,Wu MC,Lai EC,Zhou WP

    更新日期:2011-01-01 00:00:00

  • Acute ischemia of the limb in a newborn treated successfully by thrombectomy.

    abstract::A seven day old dehydrated male infant was found to have acute ischemia of the leg due to acute thrombotic occlusion of an external iliac, common and superficial femoral, and popliteal arteries. Early thrombectomy and arterioplasty resulted in complete remission of ischemia. Our success with direct vascular surgery pr...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Stavorovsky M,Iellin A,Spirer Z

    更新日期:1975-03-01 00:00:00

  • The open mesh repair of Spigelian hernia.

    abstract:BACKGROUND:Spigelian hernias are rare defects of the abdominal wall usually appearing between the abdominal muscles, lateral to the rectus abdominis and through a debilitated Spigelian aponeurosis. Recently, mesh repair has been introduced for the treatment of these types of hernias and different approaches have been p...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Celdrán A,Señaris J,Mañas J,Frieyro O

    更新日期:2007-01-01 00:00:00

  • Prospective randomized study comparing cryo-assisted and needle-wire localization of ultrasound-visible breast tumors.

    abstract:BACKGROUND:This study compared the surgical results of 2 localization methods-cryo-assisted localization (CAL) and needle-wire localization (NWL)-in patients undergoing breast lumpectomy for breast cancer. METHODS:A total of 310 patients were treated in an institutional review board-approved study with 18 surgeons at ...

    journal_title:American journal of surgery

    pub_type: 杂志文章,随机对照试验


    authors: Tafra L,Fine R,Whitworth P,Berry M,Woods J,Ekbom G,Gass J,Beitsch P,Dodge D,Han L,Potruch T,Francescatti D,Oetting L,Smith JS,Snider H,Kleban D,Chagpar A,Akbari S

    更新日期:2006-10-01 00:00:00

  • Post-extubation dysphagia in trauma patients: it's hard to swallow.

    abstract:BACKGROUND:There is a significant incidence of unrecognized postextubation dysphagia in trauma patients. The purpose of this study was to evaluate the incidence, ascertain the risk factors, and identify patients with postextubation dysphagia who will require clinical swallow evaluation. METHODS:A prospective observati...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Kwok AM,Davis JW,Cagle KM,Sue LP,Kaups KL

    更新日期:2013-12-01 00:00:00

  • Evaluation of readmissions due to surgical site infections: A potential target for quality improvement.

    abstract:INTRODUCTION:Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. METHODS:Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 201...

    journal_title:American journal of surgery

    pub_type: 杂志文章,多中心研究


    authors: Shah R,Pavey E,Ju M,Merkow R,Rajaram R,Wandling MW,Cohen ME,Dahlke A,Yang A,Bilimoria K

    更新日期:2017-11-01 00:00:00

  • Impact of recreational and medicinal marijuana on surgical patients: A review.

    abstract:BACKGROUND:As medicinal and recreational marijuana use broadens across the United States, knowledge of its effects on the body will become increasingly important to all health care providers, including surgeons. DATA SOURCES:We performed a literature review of Pubmed for articles discussing the basic science related t...

    journal_title:American journal of surgery

    pub_type: 杂志文章,评审


    authors: Bakshi C,Barrett AM

    更新日期:2019-04-01 00:00:00

  • Actual vs perceived performance debriefing in surgery: practice far from perfect.

    abstract:BACKGROUND:Performance feedback or debriefing in surgery is increasingly recognized as an essential means to optimize learning in the operating room (OR). However, there is a lack of evidence regarding the current practice and barriers to debriefing in the OR. METHODS:Phase 1 consisted of semistructured interviews wit...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Ahmed M,Sevdalis N,Vincent C,Arora S

    更新日期:2013-04-01 00:00:00

  • Radioguidance for nonpalpable primary lesions and sentinel lymph node(s).

    abstract:BACKGROUND:Radioguided surgery can also be used for the simultaneous guidance to a nonpalpable primary tumor and sentinel lymph nodes. METHODS:Retrospective review of a prospective database. The surgeon used a gamma probe for guidance to an iodine-125 labeled titanium seed at the primary lesion and technetium-99 label...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Gray RJ,Giuliano R,Dauway EL,Cox CE,Reintgen DS

    更新日期:2001-10-01 00:00:00

  • Clinicopathological analysis of local spread of carcinoma of the tongue.

    abstract:BACKGROUND:The aims of the study are three-dimensional analysis of mode and distance of local spread of oral tongue carcinoma. METHODS:The glossectomy specimens were examined in the coronal plane in 3 mm thickness section. RESULTS:There were 50 glossectomy specimens. The maximum spread was 1.8 cm. Ninety-six percent ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Yuen PW,Lam KY,Chan AC,Wei WI,Lam LK

    更新日期:1998-03-01 00:00:00

  • Mesenchymal tumor hypoglycemia: the effect of a tumor tissue extract on the insulin and glucagon secretion from the isolated perfused porcine pancreas.

    abstract::Severe fasting hypoglycemia and hypoinsulinemia occurred in a sixty-six year old woman with an intrahepatic mesenchymal tumor. An extract from the tumor was potent in inhibiting the arginine-induced glucagon secretion from the isolated perfused porcine pancreas. This observation supports the theory recently advanced t...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Jensen SL,Kühl C,Lauritsen KB,Moody AJ

    更新日期:1978-02-01 00:00:00

  • Is thyroid frozen section too much for too little?

    abstract:BACKGROUND:The role of frozen section (FS) in thyroid disease is controversial. The goal of this study was to identify a cohort of patients who may or may not benefit from FS. METHODS:Two hundred thirty-one patients who underwent thyroidectomy were evaluated in regard to fine-needle aspiration (FNA), FS, and the exten...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Richards ML,Chisholm R,Bruder JM,Strodel WE

    更新日期:2002-12-01 00:00:00

  • Feasibility, reliability and validity of a new assessment form for use with basic surgical trainees.

    abstract:BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Paisley AM,Baldwin P,Paterson-Brown S

    更新日期:2001-07-01 00:00:00

  • Real-time and the in vivo detection of minute cancer invasion to the portal-superior mesenteric vein using contact endoscopy during a pancreatic cancer resection.

    abstract::The portal-superior mesenteric vein (PV/SMV) is occasionally involved by a microscopic level of cancer invasion from pancreatic cancer even when it seems to be intact by a macroscopic inspection during surgery. Therefore, contact endoscopy, with which a high-magnification image of the methylene blue-stained PV/SMV wal...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Eguchi H,Ishikawa O,Ohigashi H,Takahashi H,Ohue M,Takenaka A,Tomita Y,Yano M

    更新日期:2009-11-01 00:00:00

  • Percutaneous Denver peritoneovenous shunt insertion.

    abstract::A simplified technique for insertion of a peritoneovenous shunt is described. By using a "peel-away" sheath at both ends of the shunt, the insertion is much quicker and less traumatic to the patient. ...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Weaver DW,Wiencek RG,Bouwman DL

    更新日期:1990-06-01 00:00:00

  • Abdominal incision and closure. A systems approach.

    abstract::The application of systems analysis and flow charting technics to abdominal incision and closure allow a complete display of objectives and alternatives. A route of alternatives has been chosen and supported by the best available principles in the surgical literature. The choices include an unconventional large bite m...

    journal_title:American journal of surgery

    pub_type: 杂志文章


    authors: Martyak SN,Curtis LE

    更新日期:1976-04-01 00:00:00