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Surgical Specialty Choice: Perceptions about Choosing Surgical Specialties for Women in Surgery
S92
Scientific Forum Abstracts
with lenti-SDF-1a exhibited a significant decrease in miR-15b expression and upregulation in VEGF-a and BCL2 expression compared to GFP-treated wounds. Histologically, SDF-1a-treated wounds demonstrated increased numbers of CD31-positive cells, indicating improved angiogenesis. CONCLUSIONS: In conclusion, SDF-1a increased angiogenesis in diabetic wounds by increasing the levels of VEGF-a and BCL2 through downregulation of miR-15b levels. These studies support a potential novel therapeutic target to modify the diabetic wound healing response and improve healing. Surgical Specialty Choice: Perceptions about Choosing Surgical Specialties for Women in Surgery Kristie Price, Maria S Altieri, MD, Nabeel R Obeid, MD, Samer Sbayi, MD, Andrew Bates, MD, Salvatore Docimo, DO, Konstantinos Spaniolas, MD, Mark A Talamini, MD, FACS, MD, FACS, Aurora D Pryor, MD, FACS Stony Brook University Hospital, Stony Brook, NY INTRODUCTION: Despite various initiatives and the increasing number of women in surgery, surgery remains a male-dominated field. Certain surgical subspecialties may be perceived as more open to women. We sought to investigate the influences that affect the choice of female surgeons to pursue a particular surgical specialty. METHODS: After Institutional Review Board approval, an 18question survey was administered to members of the American College of Surgeons (ACS) through their monthly newsletter, NewScope. Univariate analysis was used to calculate differences in responses. RESULTS: There were 615 responses to our survey; 72.10% were from males and 27.90% were from females. The largest percentage of respondents had >20 years’ experience (n ¼ 180), followed by still training (n ¼ 141). The majority of participants (n ¼ 130) were orthopaedic surgeons, followed by general surgeons (n ¼ 76) and trauma and critical care physicians (n ¼ 57). The majority of respondents identified themselves as practicing in an academic setting (n ¼ 422). Among the 23 surgical subspecialties listed, the top 3 subspecialties identified as the most open to women were breast surgery (81.8%), followed by obstetrics/gyn (69.9%), and plastic surgery (65%). Male sex was associated with more specialties that were considered open to men in comparison to women. CONCLUSIONS: This is the first survey to examine perceptions about influences that affect female choice in choosing surgical subspecialty. Most respondents identified more acceptable career options for men than women. It appears that majority of respondents perceive breast surgery to be more supportive of women. Additionally, very few survey participants reported having a female role model.
J Am Coll Surg
Technical Performance as a Predictor of Complications in Laparoscopic Gastric Cancer Surgery: Another Piece of the Puzzle Andras B Fecso, MD, Junaid A Bhatti, PhD, MBBS, Peter K Stotland, MD, FRCSC, Fayez A Quereshy, MD, MBA, FRCSC, Teodor P Grantcharov, MD, FACS University of Toronto, Toronto, ON INTRODUCTION: Laparoscopic gastrectomy for cancer is an advanced intra-abdominal procedure with a high rate of postoperative complications. Many variables, including patient, disease, and perioperative management factors have been shown to affect postoperative outcomes; however, the role of surgical performance is insufficiently investigated. The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery. METHODS: A retrospective video and chart review was performed for all patients who had undergone laparoscopic gastrectomy for cancer between 2009 and 2015. Patients with unedited video files were included in the study. Video files were rated using OSATS (Objective Structured Assessments of Technical Skills) and GERT (Generic Error Rating Tool) instruments. The main outcomes variable was short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy. RESULTS: Sixty-one patients were included in the study. The overall complication rate was 29.5%; mortality rate was 8.2%. The mean Charlson Comorbidity Index, type of procedure, and the global OSATS score were kept in the final model. Lower performance score (OSATS 29) remained an independent predictor for short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure. CONCLUSIONS: Intraoperative technical performance predicts short-term complications in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills, using modern strategies as structured feedback, deliberate practice, coaching, etc, might improve patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery. Impact of 3-Dimension (3D) Laparoscopy on Precision, Technical Performance, and Workload Shinichiro Sakata, Phillip Grove, Marcus Watson, Andrew Stevenson School of Medicine, The University of Queensland, Brisbane, Brisbane, Australia INTRODUCTION: This study compared precision of depth judgements, technical performance and workload using 2D and 3D laparoscopic displays across different viewing distances. It also compared the accuracy of 3D displays with natural viewing along with the relationship between stereoacuity and 3D laparoscopic performance.
Scientific Forum Abstracts
with lenti-SDF-1a exhibited a significant decrease in miR-15b expression and upregulation in VEGF-a and BCL2 expression compared to GFP-treated wounds. Histologically, SDF-1a-treated wounds demonstrated increased numbers of CD31-positive cells, indicating improved angiogenesis. CONCLUSIONS: In conclusion, SDF-1a increased angiogenesis in diabetic wounds by increasing the levels of VEGF-a and BCL2 through downregulation of miR-15b levels. These studies support a potential novel therapeutic target to modify the diabetic wound healing response and improve healing. Surgical Specialty Choice: Perceptions about Choosing Surgical Specialties for Women in Surgery Kristie Price, Maria S Altieri, MD, Nabeel R Obeid, MD, Samer Sbayi, MD, Andrew Bates, MD, Salvatore Docimo, DO, Konstantinos Spaniolas, MD, Mark A Talamini, MD, FACS, MD, FACS, Aurora D Pryor, MD, FACS Stony Brook University Hospital, Stony Brook, NY INTRODUCTION: Despite various initiatives and the increasing number of women in surgery, surgery remains a male-dominated field. Certain surgical subspecialties may be perceived as more open to women. We sought to investigate the influences that affect the choice of female surgeons to pursue a particular surgical specialty. METHODS: After Institutional Review Board approval, an 18question survey was administered to members of the American College of Surgeons (ACS) through their monthly newsletter, NewScope. Univariate analysis was used to calculate differences in responses. RESULTS: There were 615 responses to our survey; 72.10% were from males and 27.90% were from females. The largest percentage of respondents had >20 years’ experience (n ¼ 180), followed by still training (n ¼ 141). The majority of participants (n ¼ 130) were orthopaedic surgeons, followed by general surgeons (n ¼ 76) and trauma and critical care physicians (n ¼ 57). The majority of respondents identified themselves as practicing in an academic setting (n ¼ 422). Among the 23 surgical subspecialties listed, the top 3 subspecialties identified as the most open to women were breast surgery (81.8%), followed by obstetrics/gyn (69.9%), and plastic surgery (65%). Male sex was associated with more specialties that were considered open to men in comparison to women. CONCLUSIONS: This is the first survey to examine perceptions about influences that affect female choice in choosing surgical subspecialty. Most respondents identified more acceptable career options for men than women. It appears that majority of respondents perceive breast surgery to be more supportive of women. Additionally, very few survey participants reported having a female role model.
J Am Coll Surg
Technical Performance as a Predictor of Complications in Laparoscopic Gastric Cancer Surgery: Another Piece of the Puzzle Andras B Fecso, MD, Junaid A Bhatti, PhD, MBBS, Peter K Stotland, MD, FRCSC, Fayez A Quereshy, MD, MBA, FRCSC, Teodor P Grantcharov, MD, FACS University of Toronto, Toronto, ON INTRODUCTION: Laparoscopic gastrectomy for cancer is an advanced intra-abdominal procedure with a high rate of postoperative complications. Many variables, including patient, disease, and perioperative management factors have been shown to affect postoperative outcomes; however, the role of surgical performance is insufficiently investigated. The purpose of this study was to evaluate the relationship between technical performance and patient outcomes in laparoscopic gastric cancer surgery. METHODS: A retrospective video and chart review was performed for all patients who had undergone laparoscopic gastrectomy for cancer between 2009 and 2015. Patients with unedited video files were included in the study. Video files were rated using OSATS (Objective Structured Assessments of Technical Skills) and GERT (Generic Error Rating Tool) instruments. The main outcomes variable was short-term complications. The effect of technical performance on patient outcomes was assessed using logistic regression analysis with backward selection strategy. RESULTS: Sixty-one patients were included in the study. The overall complication rate was 29.5%; mortality rate was 8.2%. The mean Charlson Comorbidity Index, type of procedure, and the global OSATS score were kept in the final model. Lower performance score (OSATS 29) remained an independent predictor for short-term outcomes (odds ratio 6.49), while adjusting for comorbidities and type of procedure. CONCLUSIONS: Intraoperative technical performance predicts short-term complications in laparoscopic gastrectomy for cancer. Ongoing assessment and enhancement of surgical skills, using modern strategies as structured feedback, deliberate practice, coaching, etc, might improve patient outcomes. Future work should focus on developing and studying the effectiveness of such interventions in laparoscopic gastric cancer surgery. Impact of 3-Dimension (3D) Laparoscopy on Precision, Technical Performance, and Workload Shinichiro Sakata, Phillip Grove, Marcus Watson, Andrew Stevenson School of Medicine, The University of Queensland, Brisbane, Brisbane, Australia INTRODUCTION: This study compared precision of depth judgements, technical performance and workload using 2D and 3D laparoscopic displays across different viewing distances. It also compared the accuracy of 3D displays with natural viewing along with the relationship between stereoacuity and 3D laparoscopic performance.