Next in a continuing series.
Traction and counter-traction: along with maintaining excellent exposure, that is one of the fundamental principles of operating. It's Newtonian: equal and opposite. In nearly all forms of surgical dissection, there's a need for some pull in the opposing direction: tissues that are a little stretched-out, that are under some tension, fall open more easily when dissected. Plus, it's a form of stabilization, another obligatory ...
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Although I rarely get sick with the numerous strains of “bugs” that seem to go around our community this time of year, the week prior to my return to work for my next scheduled string of four shifts was spent mainly in bed, coughing and aching and whining about how miserable I felt. Fully recovered, though, I was excited to return to the emergency department to do my fair share ...
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It's a nightmare that doesn't end for the family of 24-year-old Marek Lapinski, who suffered cardiac arrest recently during the removal of two wisdom teeth in a southern California oral surgery clinic. The former college football player had no known health problems prior to the surgery, but died three days later in a hospital intensive care unit.
While the circumstances of Mr. Lapinski's death are still being investigated, the case highlights ...
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At last it was time for my cataract surgery. Having had one eye surgery done by a different physician in another New York eye and ear specialty hospital a few months earlier, I knew what to look for and could make comparisons from a patient perspective. As I noted months ago on this blog, I really had no choice of hospitals. If I wanted my trusted doctor to ...
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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
During the Civil War, anesthesia was provided by dipping cloth in chloroform or ether and holding it over a patient’s nose and mouth. Today, anesthetic medications are delivered in a controlled (and more civil) manner through specialized devices to provide unconsciousness for surgery.
Over the last several ...
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I'm involved in a protracted and good-natured (I hope) debate about the merits of robotic surgery with a University of Pittsburgh urologist named Ben Davies. Today he tweeted the following (with translation for the Twitter averse):
“I would love for a $ISRG [stock symbol for Intuitive, makers of the robot] MD hater (like @Skepticscalpel) to actually watch 10 open RRPs [radical retropubic prostatectomies] ...
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The Boston Globe recently had a front page story on how a neurosurgeon sued a patient’s husband for a blog critical of the physician.
According to the story, the patient underwent a complicated back operation as a result of her bone cancer. She tragically had a stroke post-operatively, and that’s where the situation between the family and doctor deteriorated. On the advice of his psychiatrist, the patient’s husband wrote a ...
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I’m lucky to practice in a national regional anesthesiology center, a hospital with five dedicated nerve block suites, each with the latest in ultrasound equipment, nurses trained in conscious sedation, regional anesthesiology colleagues and infrastructure to support regional practitioners. It seems like there is so much we can do for patients, but really, there is only so much a physician can do. We need a little help from the patient ...
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Years ago, I hired a carpenter to build a deck in my backyard. He showed up with a pencil behind his ear, a spiral notebook, and a tape measure. I told him what I was looking for, and he made a few suggestions. After 15 minutes of measuring and taking notes, he handed me a piece of paper with how much it ...
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The problem of medical resident work-hours has vexed medical educators for decades. The traditional model of sleep-deprived residents led to highly publicized medical mistakes, most famously the Libby Zion case in 1984.
Nobody wants tired doctors caring for them.
In response, various restrictions have been placed on how many hours medical residents are allowed to work. Since 2011, for instance, medical residents were ...
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"A comprehensive and extremely useful roadmap for doctors."
-Eric Topol, MD, author of The Creative Destruction of Medicine
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Past 6 Months
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