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The document attached has been archived with permission from the editor of the Medical Journal of Australia.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

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

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

Fellowship training in Acute Care Surgery: from inception to current state.

Recognizing the need for urgent and emergent surgical care across America, the American Association for the Surgery of Trauma developed and implemented, and oversees, the Acute Care Surgery Fellowship Training Program. Now in its 10th year, the fellowship has become an established post-General Surgery Fellowship Training Program, with 20 approved programs and 82 fellows trained. Consistent with the desire to have this non-Accreditation Council for Graduate Medical Education (ACGME) fellowship one with the highest standards, several educational improvements have occurred since its origin. The following is an account of the background and evolution of what has become a significant educational contribution to surgery

William Edwards Ladd, M.D. (1880-1967): the description of his bands.

In the early 20th century, an established surgical specialty catering to pediatric surgery did not exist, and pediatric surgical ailments were operated on by general surgeons. With his devotion to childhood diseases and his unique thinking in surgical development, William E. Ladd would become a leading figure in America by pioneering the field of pediatric surgery

Pain management in surgical patients

Acute post-operative pain is a major problem which is not well addressed clinically; with patients regularly reporting significant pain following surgery (Clark, 2006). The possible harmful effects of untested surgical pain include: deep vein thrombosis, increase in myocardial oxygen consumption, respiratory infection, muscle spasms, increase post-operative stress, anxiety, fear, sleeplessness, and possible chronic pain (Clark, 2006). The purpose of this study is to: (a) obtain local data on surgical pain intensity and patient satisfaction, (b) degree of pain relief, (c) satisfaction with pain healthcare provider’s responsiveness to patients’ reports of pain. This is a replication of Chung and Lui’s (2003) study. The sample will include patients having out patient surgery under general anesthesia. The surgical procedure will vary from general surgical procedures, ENT procedures, and gynecology procedures. Patients will be asked to consent to the survey before having surgery, monitored in recovery, and will be asked to fill out a survey in ambulatory surgery before leaving for home. The American Pain Society questionnaire was used to measure patient satisfaction with pain management. (Chung, 2003) The findings will provide information about how to increase post-operative pain relief in surgical patients.School of NursingThesis (M.S.