Category: General Surgery

Increasing rates of double mastectomies in early stage breast cancer

Interviewed by Steven E. Greer, MD

David P. Winchester MD, Medical Director of Cancer Programs for the American College of Surgeons, discusses recent data showing a more than a 100% increase in the rate that young women with early Read more »

Current surgical weight loss therapies

January 24, 2014- Interviewed by Steven E. Greer, MD

Erik Dutson, MD, weight loss surgeon at UCLA, explains why his medical center does not implant the Lap-Band, and how the “sleeve” bypass is the main procedure of choice now for weight loss surgery.

I just shook hands with a face transplant patient and did not know it

January 21, 2015- By Steven E. Greer, MD

I was in the process of being given a personal tour of the new facilities of the NYU Institute of Reconstructive Plastic Surgery when the doctor interrupted and introduced me to a patient. The adult male was Read more »

HBO’s John Oliver devotes 16-minutes on the Dr. Oz senate hearing

Atul Gawande’s surgical checklist fails in real world study

March 15, 2014- By Steven E. Greer, MD

In 2009, Atul Gawande, MD, MPH and his large international team published in the New England Journal of Medicine (NEJM) an observational study that showed a significant reduction of death and “complications” after non-cardiac surgery. The World Health Organization (WHO) created the checklist used in the NEJM paper. After this non-randomized, non-controlled, observational study was published, entire nations adopted the surgical checklist system.

Now, in 2014, a population study drawing from Ontario surgical patient data, published in the NEJM, showed no significant benefit from the widespread adoption of the same WHO surgical safety checklist that Dr. Gawande popularized. This study was also observational, but it was stronger than the 2009 Gawande study in that it included the entire population within a region.

What went wrong? Read more »

NEJM letter casts doubt on original Gawande checklist paper

June 11, 2014- By Steven E. Greer, MD

When the recent Canadian studied published in the NEJM failed to show any benefit from the WHO surgical checklist championed by Atul Gawande, The Healthcare Channel pointed out that the original Gawande paper was possibly the problem. It was designed poorly, and collected data from non-U.S. countries with little oversight.

Now, in the current online NEJM, letters to the editor are coming in. One writer echoes our concerns about the original Gawande paper. Read more »

The Massachusetts General trauma response to the Boston bombings

Interviewed by Steven E. Greer, MD

Paul Biddinger, MD, Medical Director for Emergency Preparedness, Massachusetts General Hospital and also Chairman of the Massachusetts Medical Society’s Committee on Preparedness, discusses how his hospital, and all of Boston, responded to the several hundred severely injured patients after the Boston terrorist bombs. Lesson from the battlefield helped saves lives, as did the fact that Boston possibly has more Level 1 trauma centers than any other city in the world.

Robotic surgery and controversies

January 24, 2014- Dr. Dutson gives an update on the referral patterns and safety concerns over the Da Vinci system.

Produced, Interviewed by Steven E. Greer, MD

We interviewed UCLA’s Erik Dutson, MD, surgeon and Director of UCLA’s Center for Advanced Surgical and Interventional Technology (CASIT), about the Intuitive Surgical da Vinci robotic system, and recent safety controversies.

See one. Do one. Harm one? by Peter Pronovost, MD, PhD

July 11, 2012 By Peter Pronovost, MD PhD

I recently cared for Ms. K, an elderly black woman who had been sitting in the intensive care unit for more than a month. She was, frail, weak and intermittently delirious, with a hopeful smile. She had a big problem: She had undergone an esophagectomy at an outside hospital and suffered a horrible complication, leading her to be transferred to The Johns Hopkins Hospital. Ms. K had a large hole in her posterior trachea, far too large to directly fix, extending from her vocal cords to where her trachea splits into right and left bronchus. She had a trachea tube so she can breathe, and her esophagus was tied off high in her throat so oral secretions containing bacteria did not fall through the hole and infect her heart and lungs. It is unclear if she will survive, and the costs of her medical care will be in the millions.

Ms K’s complication is tragic—and largely preventable. For the type of surgery Read more »

Julie Freischlag, MD: The new 80-hour work week surgery residency

The Surgeon-in-Chief of Johns Hopkins Hospital, Dr. Julie Freischlag, discusses how they adapted the surgery residency training from ultra-long abusive work hours down to the mandated 80-hour maximums.

 

 

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