http://opnotes.com Wed, 23 Apr 2008 19:48:18 +0000 http://backend.userland.com/rss092 en   In the old days, one could refine surgical technique with just sutures and a board of styrofoam. Now, in order to learn laparoscopy, interns and residents have to use super-expensive simulators to which most hospitals don't even have access. So even though laparoscopy is known to offer many advantages over ... http://opnotes.com/archives/169   The lower esophageal sphincter is a bothersome little junction that so often fails to do its job: either it's too loose and burps up hot acid after each meal, or it's too tight and won't let anything down. Although we jam all sorts of devices down there to determine the ... http://opnotes.com/archives/173   At SAGES we got the distinct impression that every surgical procedure known to man has a one-way ticket to NOTESville. If that's the case, then surgeons will need to get a lot more comfortable manipulating endoscopes, as their unintuitive controls tend to frighten novices. We stopped over at the Simbionix ... http://opnotes.com/archives/170 Despite all of the breathless praise being heaped on NOTES at this year's SAGES, there was still considerable excitement about single port access laparoscopy, another kind of über-minimally invasive surgery that has made great strides over the past year. In this two-part series, we'll take a look at some of the devices ... http://opnotes.com/archives/158   The exhibit hall at SAGES 2008 was something of an HD wonderland; everywhere you turned, there was another laparoscope pointing at a flower, the minute stalks of the stamen revealed in excruciating detail on a nearby flatscreen. Of all the high definition systems shown, we must say that we were the ... http://opnotes.com/archives/165 What they were looking for; what they should have been looking for.  http://opnotes.com/archives/157 Finding it increasingly difficult to figure out the latest high-tech gadgets at Best Buy? Dr. Thomas Krummel has little sympathy for you. In the annual Karl Storz Lecture, Dr. Krummel addressed the problem of surgeons innovating in an increasingly technological world.  http://opnotes.com/archives/154 Surgeons don't usually spend too much time worrying about the closure of trocar site incisions, but if the name of your game is speed, or if you find that patients wake up just a bit too quickly during suturing, then NeatStitch is your tool. The device is inserted in the trocar, ... http://opnotes.com/archives/152 During the SAGES emerging technologies session, which to us was like an early Christmas, Dr. Dmitry Nepomnayshy presented his experience using the EndoBarrier, an endoscopically-deployed impermeable tube that is placed in the duodenum to prevent absorption. Two patients have received the full treatment so far; within twelve weeks, one lost 11 pounds ... http://opnotes.com/archives/147   Sometimes a long trocar is a good thing: when your patient has a BMI of 40, for example, there will be a fair amount of abdominal fat to plow through. Sometimes, however, a long trocar is not so desirable: when you have just driven it into the aorta, say, or ... http://opnotes.com/archives/144