#surgSky

Patient Burden After Emergency Laparotomy Revealed

by Silva LM, Mohammed SA (...) Cornish JA et 5 al. in World J Surg #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article: https://onlinelibrary.wiley.com/doi/10.1002/wjs.70342

“Transparency about the eventual agreed-upon curriculum is important for all stakeholders; curriculum review committee members, learners, educators, and patients, as well as their benefactors and regulators. Benefactors could include any curricular sponsors, donors, or animal rights groups.” - Feinstein & Pawlowski (2026)

“The practical reason to replace nonhuman animals is that their use often has little relevance to the human condition” - Feinstein & Pawlowski (2026)

“When controversial models and alternatives are discussed, the alternative models, species, and learning modalities should be documented.” - Feinstein & Pawlowski (2026)

In a recent case & commentary, Drs. David Feinstein & John Pawlowki of @harvardmed.bsky.social argue that medical curricula should incorporate input from a diverse range of stakeholders, including perspectives on animal rights.

#MedEd #MedSky #SurgEd #SurgSky

Perioperative Outcomes from a Phase II Study of Robotic Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for Patients with Gastric Cancer and Limited Peritoneal Metastasis: ROBO-CHIP Trial - Annals of Surgical Oncology Introduction Traditional open cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal limited metastatic gastric cancer (GC) is associated with significant morbidity and prolonged recovery. We hypothesized that a robotic approach may significantly reduce postoperative recovery. Patients and Methods Prospective phase II, single-arm trial conducted in patients with synchronous, low volume (PCI ≤ 7) peritoneal limited metastatic GC who had completed ≥ 4 months of systemic chemotherapy were enrolled. Patients were treated with laparoscopic HIPEC followed by robotic cytoreduction, gastrectomy, and HIPEC with 175 mg/m2 paclitaxel and 100 m2/mg cisplatin. The primary end point was hospital length of stay (LOS). The secondary outcomes were 90-day postoperative complications, readmission, reoperations, and mortality. Results Between January 2023 and March 2025, 20 patients met eligibility criteria and were enrolled. Two patients subsequently progressed and were deemed ineligible for complete cytoreduction and were thus excluded leaving 18 evaluable patients. A total of 2 patients had positive peritoneal cytology only, and 16 had peritoneal carcinomatosis. Patients completed a median of 9 (IQR 8–10) cycles of neoadjuvant chemotherapy, most (72.2.%) commonly FOLFOX +/− nivolumab. The median peritoneal carcinomatosis index (PCI) at CRS/Gastrectomy and HIPEC was 6 (IQR 3–7). A complete cytoreduction was achieved in 100%. The median blood loss was 300 ml (IQR 200–450 ml) and the red blood cell (RBC) transfusion rate was 22.2%. The median operative time was 688 min (642–722 min) and the primary end point of hospital LOS was 5 days (4–6). The 90-day major morbidity, and readmission rate was 38.9% and 27.8%. There was a single (5.6%) 90-day reoperation and death. There were negligible risks attributed to HIPEC with only two (11.1%) grade IV cytopenia and one (5.9%) acute kidney injury. Conclusions Robotic cytoreduction, gastrectomy, and HIPEC for low volume peritoneal limited metastatic gastric cancer, in this highly selected patient population, is associated with favorable outcomes such as decreased hospital LOS and less blood loss/blood transfusions compared with the open approach in the literature. We continue to enroll and follow patients to assess long-term oncologic outcomes.

Robotic Surgery for Limited Peritoneal Metastatic Gastric Cancer Yields Positive Outcomes

by Buckarma E, Steadman J (...) Grotz TE et 3 al. in Ann Surg Oncol #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article:

Diverticulitis Admissions Show Seasonal Patterns Worldwide

by Cheng E, Yeh D (...) Sarofim M et 3 al. in JAMA Surg #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article: jamanetwork.com/journals/jamasurgery/ful...

Preoperative Biliary Drainage with Metal Stent Versus Early Surgery in Patients with Pancreatic Cancer: A Randomized Clinical Trial - Annals of Surgical Oncology Background Among patients with pancreatic cancer and biliary obstruction planned for pancreaticoduodenectomy, preoperative biliary drainage (PBD) may be considered during surgical delays. Higher complication rates have been reported for PBD using plastic stents versus early surgery. PBD with a self-expanding metal stent (SEMS) has not been compared with early surgery in a randomized controlled trial (RCT). Patients and Methods We conducted a noninferiority RCT comparing PBD using a SEMS versus early surgery at 11 centers in 9 countries. We enrolled patients with resectable pancreatic or periampullary cancer and serum total bilirubin level ≥ 5.8 mg/dL, scheduled for primary resection. Primary endpoint was the proportion of patients reporting ≥ 1 serious adverse event (SAE) 120 days post-randomization. Secondary endpoints included rate of SEMS insertion, rate of curative-intent resection, and all-cause mortality. Results Among 284 patients, 144 were randomized to PBD and 140 to early surgery. In the modified intention-to-treat primary endpoint analysis, ≥ 1 SAE(s) occurred in 29.0% (40/138) in the PBD group and 26.5% (36/136) in the early surgery group (between-group difference, 2.5%; one-sided upper 95% confidence limit, 11.7%; P = 0.011 for noninferiority). Among 144 PBD patients, 140 (97.2%) received a SEMS; 119 (82.6%) underwent surgery with curative intent. Among 140 early surgery patients, 14 (10.0%) underwent ERCP and drainage; 130 (92.9%) underwent surgery with curative intent in 115 (88.5%). During follow-up, 7.9% (11/138) in the PBD group and 8.0% (11/136) in the early surgery group died. Conclusion Safety following PBD using SEMS was noninferior to early surgery for pancreatic or periampullary cancer. ClinicalTrials.gov, no. NCT01774019.

Preoperative Biliary Drainage with Metal Stents Safe in Pancreatic Cancer

by Costamagna G, Reddy DN (...) Lau J et 13 al. in Ann Surg Oncol #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article:

What's it like being an editor assistant? - with Hans Lederhuber The BJS Foundation editor assistant bursaries aim to encourage young surgeons to take an interest in medical publishing. Recruited annually, editor assistant bursaries are suitable for applicants at…

📢 What’s it like to be an Editor Assistant?
Hans Lederhuber reflects on his journey with BJS and BJS Open, and what the experience has meant to him.
💡 Applications close 30 April — apply today!
🔗 buff.ly/RC6tNMT
#surgsky #medsky

BJS Academy The BJS Academy, the educational arm of the BJS Foundation, has developed a series of practical, on-demand educational resources to support high-quality surgical research and successful academic…

Most surgical trainees are expected to publish.

Few are ever taught how.

BJS Academy’s Article of the Month brings together practical, editor-led guidance on:
▪️ Writing clinical papers
▪️ Understanding peer review
▪️ Getting published in leading journals

👉https://buff.ly/Nipe3pd

#surgsky #medsky

BJS Academy Colorectal cancer (CRC) is now the leading cause of death in individuals below 50 years of age in the United States.1 While dietary fiber has been a topic of contention, the verdict is in with this…

Low fibre diet → gut inflammation → DNA damage → colorectal cancer

This isn’t theory—it’s a defined biological pathway.

Read how diet and microbial toxins interact to drive CRC 👇
buff.ly/wdm1ScX

#surgsky #medsky

Robotic Distal Splenopancreatectomy and Left Nephrectomy: Double Docking for En Bloc Resection of Pancreatic Cancer - Annals of Surgical Oncology Background Robotic approach has been demonstrated as a safe option for selected patients undergoing left pancreatectomy.1 Nevertheless, robotic approach is still uncommon in case of multivisceral resections involving the pancreas.2,3 We describe a reproducible distal splenopancreatectomy with en bloc left kidney resection for the treatment of pancreatic cancer. Patient and Methods An 81-year-old male patient was diagnosed with adenocarcinoma in the tail of the pancreas with renal infiltration. After completing neoadjuvant therapy with Gem-Abraxane, with a good response, a decision was made to perform resective surgery using a robotic approach. The teams of urology and pancreatic surgery collaborated to perform the procedure. The approach prioritized an en bloc resection with negative margin. Early identification of the renal hilum and kidney mobilization from the inferior and lateral margin facilitated further en bloc mobilization. Results Following partial kidney mobilization, the patient’s position and trocar placement were modified. The splenic artery was sectioned, and the pancreatic body was mobilised. It was then sectioned to the left of the pancreatic neck, together with the splenic vein, using an endostapler. Finally, the pancreatic tail, upper renal pole, and spleen were mobilized en bloc without detaching the three organs. The patient was discharged on postoperative day 6. Pathology results showed a T4 pancreatic adenocarcinoma with kidney invasion and two out of 26 lymph nodes involved. Conclusions The involvement of a multidisciplinary team and the option of re-docking in complex robotic procedures reduces the conversion risk and offers patients benefits by ensuring oncological radicality.

Robotic en bloc resection for pancreatic cancer is safe.

by González-Abós C, Mercader C, Musquera M and Ausania F in Ann Surg Oncol #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article:

High Satisfaction in Mentor-Mentee Surgical Programs

by Kehagias D, Popoiu T (...) Portelli M et 3 al. in Am J Surg #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article: www.americanjournalofsurgery.com/article/S0002-9610(26)00...

Surgical availability impacts patient care decisions in urgent cases.

by Abid M, Holmes GM and Charles A in J Surg Res #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article: www.journalofsurgicalresearch.com/article/S0022-4804(26)00...

Here is a shared decision-making services model.

#AnSky #MedSky #SurgSky

doi.org/10.1111/anae...

How can we integrate shared decision-making principles into patient care?

Here's a proposed pathway!

#AnSky #MedSky #SurgSky

doi.org/10.1111/anae...

PeriOperative Quality Initiative consensus statement recommendations on the definitions, aims and delivery of shared decision-making for major surgery

#AnSky #MedSky #SurgSky

doi.org/10.1111/anae...

The Clip-Pulley Maneuver: Atraumatic and Adjustable Retraction in Robotic Liver Resection - Annals of Surgical Oncology Background Precise liver retraction is essential in robotic hepatectomy. Conventional retraction methods using barbed sutures1,2 or hook-needle systems3 are penetrative and traumatic, risking diaphragmatic injury or tension pneumothorax. We developed a nonpenetrating Clip-Pulley Maneuver (CPM) to achieve safe and adjustable retraction. Materials and Methods From February to November 2025, 26 robotic hepatectomies were performed using CPM. A 3-0 polydioxanone monofilament (PDS; Ethicon, Inc., Bridgewater, NJ, USA) was placed on the liver surface at the resection margin. After suture placement, a triangular clip from the Internal Organ Retractor system (Aesculap, Inc., Center Valley, PA, USA) was introduced and the suture passed through its loop. The clip was then positioned on the diaphragm using a dedicated applicator. The suture was exteriorized through the abdominal wall using an Endo Close device (MC Medical Inc., Tokyo, Japan), forming a pulley-like system. The surgeon adjusted the traction force externally, and the assistant could reposition the clips to modify retraction direction. The direction of traction is determined by the spatial relationship between the suture placement on the liver surface and the clip position, rather than by the direction of external pulling. This setup allowed real-time, atraumatic retraction without additional punctures to the diaphragm or peritoneum. In most cases, two clips were sufficient; additional clips may be used for larger anatomical resections. Results There were no CPM-related complications or Clavien–Dindo grade III or higher events. The diaphragm remained intact in all cases. Conclusions CPM offers a safe, effective, and reusable liver retraction method for robotic hepatectomy.

Improved Liver Retraction in Robotic Hepatectomy

by Ashida R, Sugiura T (...) Uesaka K et 4 al. in Ann Surg Oncol #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article:

BJS Academy Mr. Gareth Owens, MSc. (OXON), MBCS, CITP, discusses his experiences with acute aortic dissection surgery.

❤️‍🩹 Acute aortic dissection surgery: a patient view
➡️ buff.ly/ry9SMLx

Mr. Gareth Owens, MSc. (OXON), MBCS, CITP, discusses his experiences with acute aortic dissection surgery

#surgsky #medsky @bjsurgery.bsky.social @bjsopen.bsky.social

Total Neoadjuvant Therapy Hurts Survival in Rectal Cancer

by Ito K, Jain AJ (...) Chun YS et 5 al. in BMC Surg #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article: www.sciencedirect.com/science/article/pii/S003...

BJS Academy Surgery is a planned trauma with a predictable stress response1. Yet patients are routinely sent to the operating room without preparation for the physiological demands of major surgery.…

When a trial shows “prehabilitation works”… do we actually know what worked?

🏃 Exercise?
🥗 Nutrition?
🧠 Behavioural support?
👩‍⚕️ Supervision level?

The SOS-Prehab checklist, developed by Chelsia Gillis and Julio F Fiore Jr, aims to fix this

🔗https://buff.ly/6GnDLkd

#surgsky @BJSurgery.bsky.social

Efficacy and Safety of Tranexamic Acid in Solid Cancer Surgeries: A Systematic Review and Meta-analysis of Randomized Controlled Trials with GRADE Assessment - Annals of Surgical Oncology Background There is a significant risk of blood loss and transfusion requirements during surgeries for different cancers, raising perioperative morbidity and mortality. The antifibrinolytic drug tranexamic acid (TXA) has been studied to address this issue, but the results remain conflicting. This systematic review and meta-analysis pools all available evidence regarding the use of this medication in cancer surgeries. Patients and Methods The PubMed, Scopus, Web of Science, and Cochrane CENTRAL databases were used for data retrieval until 29 April 2025. Any randomized controlled trial involving surgical patients with cancer who received TXA as the intervention was included. The main addressed outcomes were perioperative blood loss, transfusion requirements, and complications. Study quality and evidence certainty were appraised with the Cochrane RoB 2.0 tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results A total of 16 RCTs with 1830 patients were analyzed. TXA markedly reduced total, intraoperative, and postoperative blood loss compared with control. Hemoglobin changes were also smaller in the TXA group. Intraoperative blood component and perioperative red blood cell transfusions were lower with TXA. TXA was also linked to a modest reduction in operative time. No significant differences were observed between the groups for perioperative complications, reoperation rate, in-hospital or 30-day mortality, and length of hospital stay. GRADE assessments for the outcomes were mainly moderate or low, except for two that had very low certainty. Conclusions TXA appears to statistically improve perioperative outcomes in cancer surgeries while maintaining a favorable safety profile.

Tranexamic Acid Cuts Blood Loss in Cancer Surgeries

by Soliman A, Azim AAA (...) Qutob IA et 6 al. in Ann Surg Oncol #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article:

Validation of Textbook Outcome in Gastric Surgery (TOGS) for Primary Gastric Cancer in an Eastern High-Volume Center - Annals of Surgical Oncology Background Textbook Outcome defines the ideal perioperative course after surgery. A specific Textbook Outcome in Gastric Surgery (TOGS) was developed in Western centers; however, its validation among Eastern patients has rarely been investigated. We assessed its achievement in a Korean cohort and identified its predictors. Methods We included adults who underwent curative distal or total gastrectomy for gastric cancer (GC) between 2013 and 2023. TOGS consisted of three surgical criteria (no intraoperative complications, R0 resection, and adequate lymphadenectomy: > 20 nodes in subtotal and > 25 in total gastrectomy) and four postoperative criteria (no re-intervention, no unplanned intensive care unit stay, no unplanned 90-day readmission or mortality). Results Of the 5806 patients with GC enrolled, 4338 (74.7%) achieved the TOGS, with rates of 77.9% for stage I tumors and 68.8% for stages II–III. The TOGS rate declined with age, from 82.3% in patients aged < 40 years to 67.5% in those aged >80 years, with hospital readmission being the strongest negative predictor of its achievement in the elderly. Several factors were independently associated with a higher likelihood of TOGS: early lesions (P = 0.003), female sex (P < 0.001), recent surgery (P = 0.024), distal gastrectomy (P < 0.001), and minimally invasive approach (P < 0.001). Patients with TOGS had shorter hospital stays (P = 0.014) and improved 5-year overall survival (87.6%, vs. 75.6%, P < 0.001), independent of the pathological stage (stage I, P < 0.001; stages II–III, P < 0.001). Conclusions The new definition of TOGS provides valuable insights into the quality of surgical care for patients with GC and has a strong impact on oncological outcomes, including in Eastern patients.

Validation of Textbook Outcome in Gastric Cancer Surgery

by Carbone L, Cho YS (...) Lee HJ et 13 al. in Ann Surg Oncol #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article:

BJS Academy This video demonstrates the second stage of a planned two-stage repair for an extensive Type II thoracoabdominal aortic aneurysm. The first stage comprised sinotubular junction reconstruction and…

❤️‍🩹 Open Type II thoracoabdominal aortic aneurysm repair: key principles and operative insights
➡️ buff.ly/8yS4KW8

#surgsky #medsky @bjsurgery.bsky.social @bjsopen.bsky.social

BJS Academy Official portrait of President Cleveland by Eastman Johnson (1824-1906) in 1891. Grover Cleveland was the twenty-second president (March 4, 1885 – March 4, 1889) and the twenty-fourth president…

A hidden tumour.
A secret yacht.
A president fighting for political survival.

In 1893, Grover Cleveland underwent a daring and covert operation to remove a suspected cancer—without the public ever knowing.

This is where surgery meets history.
📖 buff.ly/IKe1MsO

#surgsky #medsky #history

Navigating Role Ambiguity in Surgical Education

by Cha JS, Tucker EL, Lauer KV and Smith B in J Am Coll Surg #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article: journals.lww.com/journalacs/abstract/9900...

Figure 4 of the linked paper, "Final anatomical components and modular integration into the neurosurgical simulator."

This 🆕 highly realistic, ethical, and accessible 3D-printed simulator could help replace the use of live rats in microneurosurgical training.

From Amini et al. of @uni-magdeburg.de, in @jnajournal.bsky.social:
doi.org/10.3171/2025...

#MedEd #SurgEd #MedSky #SurgSky #Neurology #Neurosurgery

BJS Academy The nomination window for the 2027 BJS Award is now open. Nominations should be submitted by Friday 26 June 2026 via the BJS Academy website, where further information is available, including the…

🎺 🎉 NOMINATIONS ARE OPEN!
➡️ buff.ly/nblBIe4

Nominate an exceptional individual for the BJS Award:

💫 Celebration of excellence in surgical science.
💫 Recognises a discovery, innovation or scientific study that has changed clinical practice.

⏳ Nominations close 26 June 2026.

#surgsky #medsky

Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority trial In patients with resectable oesophageal squamous cell carcinoma, robot-assisted oesophagectomy was non-inferior, and seemed superior, to thoracoscopic oesophagectomy in terms of 5-year overall surviva...

🆕 Robot-assisted versus conventional minimally invasive oesophagectomy for oesophageal squamous cell carcinoma (RAMIE): a multicentre, open-label, randomised, phase 3, non-inferiority trial

www.thelancet.com/journals/lan...

#GastroSky #OncSky #SurgSky

🔍WebSurg focus - esophagogastric surgery
➡️ buff.ly/QCsa9VQ

🌐Continuing our partnership with WebSurg (IRCAD), we bring you March's focus of the month🚀

#surgsky #medsky

BJS Academy To mark National Deep Vein Thrombosis (DVT) Awareness Month, we have curated a selection of recent high-impact papers from BJS and BJS Open exploring venous thromboembolism (VTE) in surgical…

🩸 March is Deep Vein Thrombosis (DVT) Awareness Month

Blood clots remain a significant yet often under-recognised risk in surgical patients — with prevention, timing, and patient selection all critical to improving outcomes.

🔍 Read it in full:
buff.ly/biYZWst

#surgsky #medsky

BJS Award A celebration of excellence in surgical science, the BJS Award recognises a discovery, innovation or scientific study that has changed clinical practice. This international accolade will give an…

⁉️Watched the 🥇BJS Award video yet?

The winner will receive:
💥€100,000
💥A medal
💥A diploma
💥Invitation to the Award ceremony
💥Host a BJS Academy webinar

REMINDER:
💥Organisations can nominate
💥Nominations can be made globally

Nominations open 2 April!

Please share ⬇️
buff.ly/EPpMtZ9

#surgsky

Prehospital Whole Blood Transfusion Not Superior in Trauma

by Smith JE, Cardigan R (...) Green L et 22 al. in N Engl J Med #Surgery #SurgSky #GeneralSurgery #MedSky

🪡 read our summary here
📖 read the article: https://www.nejm.org/doi/10.1056/NEJMoa2516043