How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons

COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice

Padiglione Piacenza. Expo Milano 2015 - EartHand Project

Expo Milano 2015 ‘eartHand Project’ Il progetto del Padiglione ‘eartHand’, costruito all’interno del grande spazio EXPO 2015, nasce dalla collaborazione tra il Politecnico di Milano Campus Piacenza (Coordinamento del progetto: Guya Bertelli; crediti a pag. 207 del volume), l’Ordine degli Architetti di Piacenza (Coordinamento: Beppe Baracchi) e la Società Piacenza EXPO, con l’obiettivo di rappresentare la città di Piacenza all’interno dell’evento: ‘Nutrire il Pianeta’. La volontà del progetto, risultato vincitore di un Concorso interno che ha visto la partecipazione di Quattro Gruppi di Architetti e collaboratori, è stata quella di mettere in evidenza l’identità del territorio nelle diverse specificità: dal patrimonio storico-culturale e paesaggistico alle eccellenze eno-gastronomiche, dalle grandi innovazioni della scienza e della tecnica alle persone che hanno portato questo territorio a essere, già storicamente, un crocevia importante di storia, cultura e popoli. Di qui la ragione della proposta, che identifica in una ‘Zolla di terra sospesa l’elemento principale capace di riassumere tutti i significati, nelle sue diverse accezioni: produzione di materia prima, trasformazione a cura dell’uomo, ricchezza proveniente dai vari processi, sedimentazione e stratificazione storica. Il titolo stesso dichiara la volontà di legare indissolubilmente due elementi: earth, la terra, l’elemento materico primigenio e generatore; hand, la mano, simbolo dell’uomo e della sua energia in grado di plasmarla. EartHand si presenta così come la grande metafora piacentina: una zolla di terra estratta dal suolo, sollevata nell’aria e trasformata in icona da trasportare nel contesto di Expo Milano 2015. Il rivestimento interno del caleidoscopio contenuto nella zolla, è stato pensato da una tecnologia avanzata in pannellature lisce, luminose e interattive. Il padiglione è stato costruito all’incrocio tra ‘cardo e decumano’ dell’impianto EXPO, definendo la così detta ‘piazzetta Piacenza’, luogo di incontro e presentazione di iniziative internazionali durante tutto il periodo dell’evento.Expo Milano 2015: 'EartHand Project' The eartHand Pavillon project originates from the collaboration between the Milan Polytechnic Campus Piacenza (Coordination of the project: Guya Bertelli; credits at pag. 2017 of the Volume), the Order of Architects of Piacenza (Coordination: Beppe Baracchi) and the Piacenza EXPO Society, with the aim of representing the city of Piacenza in the EXPO 2015 event: 'Feeding the Planet'. The will was to highlight the identity of the territory in the different specificities: from the historical-cultural heritage to the eno-gastronomic excellences, from the great innovations of science and technology to the people who brought this territory to be, already historically, an important crossroads of history, culture and peoples. Hence the reason for the project, which identifies in a 'Zolla di terra sospesa the main element able to summarize all the meanings, in its different meanings: production of raw material, transformation by man, wealth coming from the various processes, sedimentation and historical stratification. The title itself declares the desire to indissolubly link two elements: earth, the earth, the primitive and generating material element; hand, the hand, symbol of man and his energy capable of shaping it. EartHand infact presents itself as the great Piacenza metaphor: a clod of earth extracted from the ground, raised in the air and transformed into an icon to be transported in the context of Expo Milano 2015. The internal coating of the kaleidoscope contained in the plate was conceived by an advanced technology in smooth, bright and interactive panels. The Pavillon was built inside the crossroad formed by ‘Cardus and Decumanus’ of the EXPO site, creating the new ‘Piacenza little square’, a place for meetings and other international initiatives

Preoperative Endoscopic Sphincterotomy Versus Laparoendoscopic Rendezvous in Patients With Gallbladder and Bile Duct Stones

OBJECTIVE: To compare success rate, length of hospital stay, clinical results, and costs of sequential treatment (endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy) versus the laparoendoscopic Rendezvous in patients with cholecysto-choledocholithiasis. BACKGROUND: The ideal management of common bile duct (CBD) stones in the era of laparoscopic cholecystectomy (LC) remains controversial. METHODS: A total of 91 elective patients with cholelithiasis and CBD stones diagnosed at magnetic resonance cholangiography (MRC) were included in a prospective, randomized trial. The patients were randomized in 2 groups. Group I patients (45 cases) underwent a preoperative endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy (ES) followed by LC in the same hospital admission. Group II patients (46 cases) underwent LC associated with intraoperative ERCP and ES according to the rendezvous technique. RESULTS: The rate of CBD clearance was 80% for Group I and 95.6% for Group II (P = 0.06). The morbidity rate was 8.8% in Group I and 6.5% in Group II (P = not significant). No deaths occurred in either group. Hospital stay was shorter in Group II than in Group I: 4.3 days versus 8.0 days (P < 0.0001). There was a significant reduction in mean total cost for group II patients versus group I patients: €2829 versus €3834 (P < 0.05). CONCLUSIONS: When compared with preoperative ERCP with ES followed by LC, the laparoendoscopic rendezvous technique allows a higher rate of CBD stones clearance, a shorter hospital stay, and a reduction in costs