Who will do general surgery?

The document attached has been archived with permission from the editor of the Medical Journal of Australia. An external link to the publisher’s copy is included.Advantages to patients of a single anaesthetic for more than one operation are obvious; attracting generalist surgeons, training them and ensuring they have adequate credentials remain hurdles.Martin H Bruening and Guy J Madder

Message from the Dean and the Chairman of Dental Surgery

The first course of Dental Surgery at the (Royal) University of Malta commenced in October of 1933 in the Faculty of Medicine and Surgery. Recognition of the Diploma in Dental Surgery by the General Medical Council of the UK was granted in 1936, a year before the end of the course. (The General Dental Council as a distinct regulatory body was established later). Dental Surgery become a Faculty , separate from Medicine and Surgery, in 1954. St. Luke's Hospital has since then also been designated a Dental Teaching Hospital. The most serious problem facing the Department at this stage of development is the uncertainty associated with the move to the new hospital, We are scheduled to move in Phase Three whenever that maybe.peer-reviewedpeer-reviewe

Day surgery and general anaesthesia : what makes patients anxious?

For many patients the prospective of undergoing surgery and general anaesthesia is highly anxiety provoking. With the global rise in day surgery and limited nurse/ patient contact, anxiety has become a prominent issue. The aim of the study was to establish the degree of anxiety arising from elective day surgery and general anaesthesia and uncover specific anxiety provoking aspects. Day surgery patients (n=460) completed a questionnaire during recovery at home and return it by post. The majority of patients (85%) were anxious on the day of surgery and 50% desired a detailed level of information. Anaesthetic information provision, catastrophising and imminence of surgery were deemed to be reliable predictors of anxiety. The planned provision of anaesthetic information in advance of the day of surgery, emphasising ‘controlled unconsciousness’, provision of information to help limit catastrophising thoughts and assistance to reduce the impact of ‘waiting’ are recommended for the effective management of anxiety

News in Brief

Matthew P. Jenkins, MD, has joined the Division of Plastic Surgery. Dr. Jenkins completed his general surgery residency at Temple University Hospital in 2013 and remained there for fellowship training in Plastic and Reconstructive Surgery. He is board certified and sees patients at Thomas Jefferson University Hospital. Anirudh Kohli, MD, has joined the Division of Acute Care Surgery. Dr. Kohli completed his general surgery residency at the Montefiore Medical Center at the Albert Einstein College of Medicine in New York, followed by a fellowship in Surgical Critical Care at Cooper University Hospital in Camden, NJ. He is board certified and sees patients at Thomas Jefferson University Hospital and on the Main Line. Matthew W. LaPorta, MD, has joined the Division of Acute Care Surgery. Dr. LaPorta completed his internship and four years of surgical residency at INOVA Fairfax Medical Campus in Falls Church (IFMC), Virginia. After residency, Dr. LaPorta remained at IFMC to complete a fellowship surgical critical care. He is board certified and sees patients at Thomas Jefferson University Hospital and on the Main Line. Louis E. Samuels, MD, FACS, has joined the Division of Cardio-thoracic Surgery. Dr. Samuels completed a general surgery residency, followed by a cardiothoracic residency at Hahnemann University. He has had a faculty appointment as a Professor of Surgery at Thomas Jefferson University since 2012. As a member of the full time staff here at Jefferson, he will now have a teaching relationship with our surgical residents and fellows. Dr. Samuels sees patients at Thomas Jefferson University Hospital. Gerald A. Isenberg, MD, FACS, Professor of Surgery, has been named Editor in Chief of ACS Case Reviews in Surgery, a new journal from the American College of Surgeons. The inaugural issue will be published in winter of 2017. Congratulations to Jonathan Brody, PhD, on his promotion to Professor of Surgery and Pathology, Anatomy and Cell Biology. Dr. Brody is the Vice Chair for Research and Director, Division of Surgical Research. Congratulations to Geoffrey Ouma, DO, on his promotion to Clinical Assistant Professor of Medicine and Surgery. Dr. Ouma is a vascular medicine specialist at the Jefferson Vascular Center. Congratulations to Francesco Palazzo, MD, FACS, on his promotion to Associate Professor of Surgery. Dr. Palazzo is Vice Chair of the Department of Surgery and Chief of Surgery at Methodist Hospital. Congratulations to Zi-xuan (Zoe) Wang, MD, on her promotion to Associate Professor of Pathology and Surgery. Dr. Wang is Scientific Director of the Molecular & Genomic Pathology Lab

Anesthesia in the surgery of strabismus: role of anesthetic agents in the ocular deviation and surgical outcome

Purpose: To determine whether the changes in the ocular alignment following general anesthesia, maintained with two different inhalational anesthetic agents, sevoflurane and desflurane, can be used as a predictor for surgical outcomes in children with esotropia. Methods: The authors obtained digital photographs of 42 children with esotropia; 21 patients underwent strabismus surgery with general inhalation anesthesia with sevoflurane (group A), 21 patients with inhalatory anesthesia with desflurane (Group B), as maintenance general anesthesia agents. For each patient, the corneal reflexes position were digitally measured and compared with the preoperative ocular deviation’s angle; the correlation with surgical outcome, one year after, was considered. Results: The patients in both groups showed a decrease of the squint angle, or eye’s gap position after the induction of general anesthesia. In group B, this divergence was significantly higher than in group A (P<0.001). In both groups, there was a linear correlation between the preoperative angle and shortly after the induction of general anesthesia. Patients ranging a corneal reflexes position within 1 SD (15Δ) evidenced higher success of surgery (p<0.05) of patients>1 SD. Conclusion: Changes in the ocular deviation with sevoflurane and desflurane, can be predictive for surgery outcome in children with esotropia. Furthermore, desflurane evidenced greater effects on the ocular deviation compared to sevoflurane, thus confirming to be the inhalational anesthetic of choice in strabismus surgery

William Arbuthnot Lane (1856-1943): Surgical Innovator and His Theory of Autointoxication.

William Arbuthnot Lane contributed to the advancement of many fields of orthopedics, otolaryngology, and general surgery. He is credited for his no-touch technique and the invention of long-handled instruments, some of which are still in use today, to minimize tissue handling. He is most well known for his hypothesis that slowing of gastric contents could cause a variety of ailments and this became known as Lane\u27s disease. Although his surgical treatment of Lane\u27s disease is now defunct, it advanced the surgical technique in colorectal surgery. It seems likely that some of Lane\u27s autointoxication patients would be classified today as patients with colonic inertia, diverticulitis, colonic volvulus, and megacolon or, which are all treated with colectomy. Lane was a pioneer in multiple fields and a true general surgeon. He advanced colorectal surgery immensely and propelled the field of surgery into a new era

Dehn surgery on knots in S3S^3 producing Nil Seifert fibred spaces

We prove that there are exactly $6$ Nil Seifert fibred spaces which can be obtained by Dehn surgeries on non-trefoil knots in $S^3$, with $\{60, 144, 156, 288, 300\}$ as the exact set of all such surgery slopes up to taking the mirror images of the knots. We conjecture that there are exactly $4$ specific hyperbolic knots in $S^3$ which admit Nil Seifert fibred surgery. We also give some more general results and a more general conjecture concerning Seifert fibred surgeries on hyperbolic knots in $S^3$.Comment: 11 page