Posts Tagged ‘surgeon’

Experience is privileged in the field of surgery

Tuesday, February 5th, 2013

 

The patients, who have suffered a surgical intervention by an experienced surgeon, have a rate of mortality on long term with 22% inferior to those who have been treated by surgeons with a lower volume of surgical interventions in their list of achievements.

According to which criteria should one chose his/her doctor or surgeon in case of a relatively severe disease? The experience is an important factor of the doctor´s quality. A new proof has been given by Swedish researchers who have substantiated that a patient suffering of oesophagus cancer benefits from a longer survival on long term if he/she has been operated on by an experienced surgeon, who has the experience of such difficult interventions, in comparison with a novice or a doctor not specialized in this pathology. As one could have suspected, they have substantiated it in a masterly manner. The researchers at the Institut Karolinska, who have published their result on the 7th of January in The Journal of Clinical Oncology , estimate that the surgery of the oesophagus cancer should be concentrated in the hands of licensed surgeons.

The surgical removal is the basic treatment of the esophagus cancer. This is a difficult intervention, but it allows to a certain number of patients to be healed and to others to have a survival of more than 5 years. The Swedish study tilted on 1335 operated patients between 1987 and 2005 in Sweden, who have benefited from a regular supervision until 2011. The authors analyzed the global surgical volume of the hospitals where each patient has been operated on, the number of this kind of interventions realized each year by the surgeon being in charge of the patient and his/her experience accumulated in the respective field since the end of the academic course. They have then analyzed the survival period of the patients according to the surgeon´s experience.

The results are quite spectacular, as the patients operated on by physicians having a high cumulated surgical volume  present a less than 22% long term mortality risk in comparison with the surgeons having a low surgical volume in their list of achievements in this kind of pathology. However, the hospital´s surgical volume has no effect on the long term survival. It is clear for the researchers having led this evaluation, that this type of surgery must be centralized to some surgeons having a great experience in these important and difficult interventions.

The question of the surgeon´s training exceeds the framework of the oesophagus cancer. A study in France has shown, for example, that concerning the removal of the prostate for cancer reason, the risk of death during the surgical intervention is multiplied by 3,5 when the surgeon makes less than 50 removals per year, in comparison with the surgeon who makes more than 100.

Source of the article here

The German experience of a young Romanian Surgeon

Tuesday, December 11th, 2012

Once Romania entered the European Union in 2007, significant advantages for the highly skilled and educated were created with the liberalization of the labor-market.

Gabriel B. lives in Germany since 2007, and is currently in the 5th residency year as a General Surgeon. After graduating medicine in 2007, Gabriel moved to Nordrhein-Westfalen in a city with about 25 000 inhabitants in order to start his medical career.

The hospital in which Gabriel is currently working, benefits of 150 beds for inpatient care and 59 beds for the surgical department. Offering high quality diagnostic and therapeutic procedures with comprehensive and modern medical equipment, combining high tech medical care with humanity and personal attention is a high priority of the hospital. The hospital benefits from:

  • CT scanner
  • Ultrasound devices
  • High quality video and X-ray systems
  • Zeus and Cicero devices

“Starting off in a smaller city and a smaller hospital is ideal for foreign doctors. Accommodation with the system and integration in the medical team is the key factor and one of the hospitals focal points when it comes to foreign doctors. Colleagues are patient and helpful, soon I felt like part of the team”, stated Gabriel.

“Social integration is also not an issue. Living in a smaller city, and working with people for people, especially in the respected field of medicine grants you rapid recognition. People greet me on the street, so we get to know each other resulting to mutual respect and of course friendship.

But, of course social integration does not only mean receiving recognition, it also means sharing interests. For example Germans value their gardens, spending a decent amount of their time gardening and making their front and back gardens esthetic. Of course they also love their home, their cars, their sports and to travel,” added Gabriel.

“The home environment is another plus. I enjoy getting to live in a two story house with a beautiful front and back garden in a nice and peaceful neighborhood. I don’t live by myself in the whole house, I have upstairs neighbors but its ok we don’t bother one another, the house has different entrances so we don’t have to bump into one another unless we want to”, stated Gabriel.

A common misconception is created when it comes to thinking about smaller cities. People think that smaller cities bring no opportunities for leisure and entertainment, schools and employment for the rest of the family.

“I can honestly say that in a radius of 20km you can find everything! Pharmacies, schools, kindergartens, cinemas, theaters, malls, stores like H&M or Zara, restaurants ranging from Chinese, Italian and Turkish to restaurants with traditional German food, and of course McDonalds and Burger King.

Sports and other outdoors leisure activities are also easily accessible. Tennis courts, football fields, swimming-pools and indoor swimming pools are close by. Spas and Gyms are easily accessible. Besides all the above, Nordic walks, hiking and biking are sought after activities here in Germany”, stated Gabriel.

Getting from A to B

“One of the most important things about Germany is its infrastructure. Airports, highways, freeways, bike lanes, public transport… they all seem to eat up the distance between different cities, counties and even different countries. No wonder the Germans love to travel!” stated Gabriel.

“I can honestly say I’m proud to make part of the community in the city I live and work in”, Gabriel B.

Gaming technology implemented in surgery

Wednesday, June 6th, 2012

 

Doctors in London are currently trialing “touchless” technology often used in TV games, to help them carry out delicate keyhole surgery.

The link between this:

and this:

The system allows them to manipulate images with their voice and hand-gestures rather than using a keyboard and a mouse. The surgeons currently working on perfecting the procedure state that these means of control helps them avoid disruption.

For now the forecast is outstanding. The doctors working on this project believe this can become a standard procedure over the next 10-15 years. The new wave media technology such as 3D imaging has already become a reliant tool to carry out complex procedures.

Manipulate images

Surgeons at St. Thomas hospital in London are trialling gesture-based gaming technologies to access and manipulate images.

This system will be familiar to anyone who has used Kinect interactive games at home.

This has been adapted to respond to surgeons voice commands and arm-movements during operations.

The initial trial at St. Thomas hospital is in vascular surgery, for procedures such as inserting a graft to repair a damaged aorta, the main blood vessel running through the body.

Standing straight, arms raised like an conductor, the surgeon, Tom Carrell, issues commands to a Kinect sensor perched beneath a monitor displaying a 3D image of the patient’s damaged aorta.

With hand gestures he can pan across, zoom in and out, and rotate images. He can then lock the image and make markers to help ensure the graft is in exactly the right place.

“Easy to use”

He says this direct control helps him to focus on the technical aspects of the operation

“Until recently, I was shouting out across the operating theatre to tell someone to go up, down, left right. But with the Kinect I’m able to get the position that I want quickly – and also without me having to handle non-sterile things like a keyboard or mouse during the procedure.”

Mr. Carrell says the technology is easy to use.

“The sensitivity is the main thing, but it’s very simple gestures, like on a smart-phone. Once you know the gestures it’s very intuitive.”

This is one of the first trials of its kind in the world. Some of the features such as the voice control and gestures tailored to vascular surgery – are unique.

“Constrained area”

The refinements from gaming technology to complex surgery have been developed by Microsoft Research, with support from Lancaster University. Helena Mentis from Microsoft Research says the operating theatre presents particular challenges.

“In something like a surgical theatre we’re interested in a very constrained area. You have surgeons and scrub nurses that are all very close to one another. You have a patient in front of you. You don’t have the ability to reach up and reach out as far because you’re sterile. You can’t touch anything that’s not already sterile.”

Early days

This trial will soon be extended to other centers and other types of surgery. John Brennan, who is president of the British Society for Endovascular Therapy, says the procedure is still in its early days but the potential is great.

“I think these sort of advances in image manipulation which is an integral part of the a lot of the minimally invasive stuff that is done nowadays – inevitably it’s going to become more refined and available. I would find it difficult to think about operating rooms in ten or 15 years time where these were just not the norm”

Dr. Mark Rouncefield from the School of Computing and Communications at Lancaster University welcomed the trial.

“This is a lovely example of a successful interdisciplinary research project, combining the technical skills of computer scientists with a social scientific and medical expertise that ensures the new technology resonates with the way in which surgeons actually do their work.”

 

Source of the article here