Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “General Surgery”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1989

Surgical research: its importance in the evolution of the specialty of general surgery.

General surgery is a specialty that has gradually been defined by the evolution of surgery in general, the major events being the identification and separation of subspecialties. Advances in knowledge brought about by research have been the major determinants in allowing the development of these subspecialties. Research has played a major role in the redefinition of general surgery, which has now in its own right become both the parent specialty and a subspecialty: the parent specialty because of its continued concern with disease states of a general nature, such as trauma, critical care, nutrition, transplantation, oncology; a subspecialty because of its focus on specific areas of surgery, particularly gastrointestinal surgery. Future developments in general surgery depend on fostering research in both the general and specific areas, and also across the whole spectrum from the most basic to applied clinical research.

Canada↗
PubMed1994

Laser safety programs in general surgery.

General surgery represents a speciality where, while any procedure can be performed with lasers, there are no procedures for which the laser is the sine quo non. The general surgeon may perform a variety of procedures with a multitude of laser wavelengths and technologies. Laser safety in general surgery requires a multidisciplinary approach. Effective laser safety requires the oversight of the hospital's "laser usage committee" and "laser safety officer" while providing a workable framework for daily laser use in a variety of clinical scenarios simultaneously. This framework must be user-friendly rather than oppressive. This presentation will describe laser safety at the Rochester General Hospital, a tertiary care, community-based teaching hospital. The safety program incorporates the following components: input to physician credentialing and training, education and in-servicing of nursing and technical personnel, equipment purchase and maintenance, quality assurance, and safety monitoring. The University of Rochester general surgery residency training program mandates laser training during the PGY-2 year. This program stresses the safe use of lasers and provides the basis for graded hands-on experience during the surgical residency. The greatest challenge for laser safety in general surgery centers on the burgeoning field of minimally invasive surgery. Safety assurance must be balanced so as to maintain a safe operating-room environment while ensuring patient safety and the ability to permit the surgery to proceed efficiently. Safety measures for laparoscopic procedures must be sensitive to the needs of the surgical team while not providing confusing signals for the "gallery" observers. This task is critical for the safe operation of lasers in general surgery. Effective laser safety in general surgery requires constant vigilance tempered with sensitivity to the needs of the surgeon and the patient as laser technology and its applications continue to evolve.

Credentialing↗
PubMed2004

Choice of vascular surgery as a specialty: survey of vascular surgery residents, general surgery chief residents, and medical students at hospitals with vascular surgery training programs.

PURPOSE: Under the direction of the Association of Program Directors in Vascular Surgery, a survey was mailed to vascular surgery residents (VSRs), general surgery chief residents (GS-CRs), and fourth-year medical students (MSs) to better define reasons why trainees do and do not choose vascular surgery as a career. METHODS: Questionnaires were mailed to all accredited VSR programs and their associated GS programs in the United States and Canada in 2001 (survey 1) and in 2003 (survey 2) and to 2 medical schools with VSR programs in 2001. A total of 197 VSRs, 169 GS-CRs, and 78 MSs responded (overall program response rate of 78% for VSRs, 46% for GSRs, 20% for MSs). A scoring system was assigned, with 1.0 the least important and 5.0 the most important reasons to choose or not choose vascular surgery. RESULTS: Technical aspects, role of mentors, and complex decision making involved in vascular surgery were the most important reasons that VSRs, GS-CRs, and MSs would choose vascular surgery as a specialty (average scores > or =4.0 for VSRs and GS-CRs; > or =3.5 for MSs). Responses of GS-CRs and VSRs did not vary significantly between surveys 1 and 2, except endovascular capabilities of vascular surgeons had a more important role in choosing vascular surgery, and future loss of patients to other interventionalists had a more important role in not choosing this specialty in the more recent survey of GS-CRs and VSRs. MSs identified lifestyle as a surgical resident (4.3) and as a surgeon (4.2) as the most important negative factors. A training paradigm consisting of 4 years general surgery + 2 years vascular surgery with a GS certificate was favored by 64% of GS-CRs and 48% of VSRs, compared with a paradigm of 5 years + 2 years with a general surgery certificate, which was favored by 29% of GS-CRs and 25% of VSRs, or 3 years + 3 years without a general surgery certificate, favored by 7% of GS-CRs and 27% of VSRs. Of note, 86% of MSs favored 3 years general surgery + 3 years vascular surgery or 2 years general surgery + 4 years vascular surgery compared with longer general surgery training periods. CONCLUSION: These findings may help vascular surgery program directors devise strategies to attract future trainees. The importance of mentorship to general surgery junior residents and medical students in choosing vascular surgery cannot be overestimated. Endovascular capabilities of vascular surgeons have an increasingly positive role in career choice by GS-CRs and VSRs, but these residents express increasing concerns about potential loss of patients to other specialists. Lifestyle concerns are the most important reasons why medical students do not choose vascular surgery as a career.

Adult↗
PubMed1993

General surgery, the general surgical subspecialties, and prerequisite training.

Currently, several specialties (cardiothoracic, pediatric, and colorectal) require a full general surgery residency before specialty training. Plastic surgery has, in essence, a de facto requirement since most residents have had at least 5 years of general surgery training before initiation of a plastic surgery residency. Forces within both general surgery and plastic surgery will dictate that such a de facto requirement will not persist in the future. The pressures that compel plastic surgery to modify the traditional role of general surgery as preparatory training for requisite or specialty residency training can be extended by analogy to the other specialties as well. This article will hypothesize that the premises and the conclusions about the relationship between plastic surgery and general surgery apply equally well to the other specialties. If the traditional and historical role of full general surgery residency as prerequisite training for a specialty residency is discarded, careful thought must be given to any substitute system to graduate surgical education. In particular, attention must be directed to the three components of clinical skills to be acquired and to an expectation of operative or technical experience.

Certification↗
PubMed2003

[The new Japanese board of surgery for general surgery specialists].

The postgraduate training and board certification system for general surgery has just reached a new era with the upgrading from the previous system for registered surgeons. The new system consists of first-step training of a minimum of 5 years (initially 4 years or more) covering general surgery, emergency medicine, and basic knowledge of subspecialties. The subspecialties programs are optional but combined as the second step, and 7 years of training including the first step are required. The new system of a general surgical training consists of a residency training program with registered hospitals and a minimum requirement of surgical experience. At this starting point, the Japan Surgical Society should take responsibility for this new training system, together with the related societies of subspecialties, in this new step for the official and adequate public qualification of surgeons.

Education, Medical↗
PubMed2003

Vascular surgery training in general surgery residency programs: the Canadian experience.

OBJECTIVES: Vascular surgery is traditionally considered a component of general surgery. There is growing evidence of improved patient outcome related to surgeon volume and vascular certification status. The American Board of Surgery in the United States, as well as until recently the Royal College of Physicians and Surgeons in Canada, requires that vascular surgery be considered an essential content area of general surgery training. This requirement is controversial. The purpose of this study was to describe experience and perceived competence in common vascular surgery procedures during general surgery residency training in Canada. METHODS: This web-based survey was conducted between January and June 2002. General surgery program directors (GSPDs), vascular surgeons involved in general surgery training programs (VSs), and senior general surgery residents (SRs) from the 13 English-speaking general surgery programs in Canada were surveyed. Questions were asked regarding which vascular surgery procedures are appropriate for general surgeons to perform, which procedures SRs are trained to perform, and which procedures SR intend to perform. RESULTS: The response rate was 62% for GSPDs, 57% for VSs, and 45% for SRs. Overall, 49% of SRs did not intend to perform any vascular procedures after training. GSPDs, VSs, and SRs indicated that most SRs should be and are trained to perform varicose vein surgery, leg amputation, and femoral embolectomy (P >.05). In addition, GSPDs, VSs, and SRs indicated that SRs should not be and are not trained to perform infrainguinal bypass grafting, carotid endarterectomy, or abdominal aortic aneurysm (AAA) repair (P >.05). There were significant differences with respect to ruptured AAA repair: 49% of SRs, 25% of PDs, and only 12% of VSs believe that general surgeons should be trained to perform ruptured AAA repair (P <.05). Overall, 76% of VSs believe SRs receive too little vascular training. CONCLUSION: There is similarity between GSPDs, VSs, and SRs with respect to vascular surgery training in Canadian general surgery programs. Vascular surgery training cannot be considered a component of general surgery. More rotations or fellowship training is required to become competent in management of common vascular surgery procedures. Perhaps this level of competence should not be an objective of general surgery training.

Canada↗
PubMed2003

Difficult laryngoscopy: incidence and predictors in patients undergoing coronary artery bypass surgery versus general surgery patients.

OBJECTIVE: Cardiac surgery patients might have a higher incidence of difficult laryngoscopy than the general population because of older age, dental problems, and obesity. The authors estimated the incidence and predictors of difficult laryngoscopy in coronary artery bypass surgery patients. DESIGN: Prospective, controlled study. SETTING: University setting. PARTICIPANTS: Patients undergoing coronary artery bypass or general surgery. INTERVENTIONS: Two hundred consecutive patients undergoing coronary artery bypass graft and 444 general surgery patients, all aged >40 years, were compared for the incidence and predictors of difficult laryngoscopy, defined as a grade III or IV view. MEASUREMENTS AND MAIN RESULTS: Predictors of difficult laryngoscopy were considered mouth opening <4 cm, limited cervical mobility, thyromental distance <6 cm, protruding or partially missing upper teeth, and Mallampati classes 3 and 4. More cases of difficult laryngoscopy were recorded in cardiac patients (10% v 5.2%, p <0.023). The cardiac patients were older, mostly men, and belonged to ASA III-IV risk classes. Mallampati classes 3 and 4 were more frequent in the control group. With univariate analysis, difficult laryngoscopy correlated with 7 variables: older age, ASA-IV risk class, protruding or partially missing upper teeth, limited mouth opening, limited neck movement, thyromental distance <6 cm, and diabetes mellitus. Multivariate analysis adjusted for propensity score identified older age (odds ratio = 1.05/yr, 95% confidence interval = 1.005-1.09, p < 0.03) and limited neck movement (odds ratio = 9.5, 95% confidence interval = 2.2-41, p < 0.003), but not cardiac surgery per se, as independent predictors of difficult laryngoscopy. CONCLUSIONS: Difficult laryngoscopy was more frequent in cardiac surgery patients (10% v 5.2%). Older age and limited neck movement, but not cardiac surgery per se, were independent predictors of difficult laryngoscopy.

Adult↗
PubMed2002

The generation gap in modern surgery: a new era in general surgery.

General surgery remains one of the most respected residencies available to medical students today. At the same time, the number of medical school graduates applying for general surgery residencies continues to decline. Despite this decline, we still search for those individuals exhibiting qualities shared by general surgeons who excel. Although the field of general surgery is constantly evolving, these qualities remain the same. While intellect and good technical skills are essential, they alone do not ensure success as a surgery resident. Confidence, stamina, tenacity, and patience are imperative. Good leadership, motivational, and decision-making skills are also vital characteristics. Finally, the importance of dedication to patient care cannot be overstated. Because disease, injury, and pain are not scheduled events, general surgery residents regularly spend long hours, day and night, caring for and worrying about their patients. To ensure that we continue to add a sufficient number of general surgery residents each year without lowering our standards, those of us in general surgery must attempt to determine why fewer medical school graduates are applying for general surgery residencies. Then we must find ways in which we can improve the residency programs and, probably more important, emphasize to students the things about this field that led us to devote our lives to its practice.

General Surgery↗
PubMed1995

The future of general surgery characterized by general surgical chief residents.

The future of any specialty in medicine depends in large part on the career choices of its trainees. We obtained data from General Surgery Chief Residents who finished their training in 1990 and compared their attitudes to a similar survey conducted by us in 1985. According to those responses, residents in general surgery continue to choose fellowship training at a time when they no longer perceive an oversupply of general surgeons. This has broad implications for the future of general surgery as a specialty that requires significant change in the structure of our residency programs.

Attitude of Health Personnel↗