Background: Natural Orifice Transluminal Endoscopic Surgery (NOTES) represents the ultimate expression of minimally invasive surgery. Unlike in other areas where a healthy organ is perforated in order to address the diseased organ, in rectal surgery a natural orifice transanal approach allows for surgical access to perform a proper oncologic resection. We have developed and present here an initial feasibility and safety study of transanal total mesorectal excision (TME) with splenic flexure rele
Background: As clinical outcome data becomes more closely tied with hospital reimbursement, understanding the balance between providing quality care and training surgical residents becomes more important. We sought to determine if resident participation in this type of complex laparoscopic bariatric case affected 30 day morbidity and mortality of patients using the ACS NSQIP database.
Methods: We queried the ACS NSQIP database from 2005-2012 using CPT codes for laparoscopic gastric bypass. Case
Introduction: Redo paraesophageal hernia repair is uncommonly performed for recurrent hiatal hernia and/or reflux with little understanding as to outcomes related to perioperative and subjective patient variables. The aim of this study is to understand what differences exist between patients undergoing initial paraesophageal hernia repair (IPEH) and those undergoing redo paraesophageal repair (RPEH).
Methods: A review of all PEH repairs between 2009 and 2013 was performed from a single instit
?Background: In 2006, Centers for Medicare & Medicaid Services restricted coverage for bariatric procedures to designated high-volume Centers of Excellence (COEs) in an effort to improve outcomes. This policy has subsequently been reversed as the resultant improvement in outcomes was not substantiated. Regionalization remains a strategy recommended to improve outcomes for other complex surgical procedures. In an attempt to examine the effects of regionalization on access to care, we used the bar
Introduction: Healthcare systems and surgeons are under increasing pressure to provide high quality care for the lowest possible cost. This study utilizes national data to examine the outcomes and costs of common laparoscopic procedures based on hospital type, size, and location.
Methods: The National Inpatient Survey (NIS) was queried from 2008-2011 for five laparoscopic procedures: colectomy (LC), inguinal hernia repair (LIHR), ventral hernia repair (LVHR), Nissen fundoplication (NF), and cho