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This text provides a comprehensive review of the ethical issues involved with the development, evaluation, and introduction of new treatments of gastrointestinal diseases. How several landmark surgical innovations were developed are described to show the challenges faced, and the ethical dilemmas these innovators dealt with. The challenges of dealing with regulatory issues, and how to work with industry partners, and investors when working on a new therapy is described. Once a new technology has been brought to the market, standards need to be developed regarding the training, credentialing and adoption of the new technology. There are insufficient standards of how to balance the desire to provide patients the latest therapy with the obligation that patients receive informed consent about the new technology, and the relationship that the physician may have had with product development. The book describes the national perspective of paying for new technology, and provides one insurance company’s approach to the introduction of innovative therapy. The Sages Manual Ethics of Surgical Innovation will be a resource for surgeons, researchers and health policy personnel to understand the ethical issues related to the development, introduction and adoption of innovative therapies for gastrointestinal diseases. Although the context for discussion is the application of innovation to gastrointestinal disease, the ethical issues are applicable to any discussion of innovative medical or procedural therapies.
In this thoroughly revised second edition of the frequently downloaded manual, The SAGES Manual of Quality, Outcomes, and Patient Safety. A panel of experts update and expand their survey of the many factors that influence quality in the world of surgery, surgical outcomes, and threats to patient safety. Among the highlights include a section devoted to threats to quality and outcomes and safety, such as surgeon wellness and burnout, disruptive behavior, second victims, the surgeon with declining skills, and maintaining quality in the setting of a crisis. Another all-new section focuses on surgical controversies, such as whether or not to use robotic surgical technology and whether or not it influences surgical outcomes; whether or not routine cholangiography reduces the common bile duct injury rate; whether or not having a consistent operating room team influences surgical outcomes, and whether a conflict of interest truly influences surgical quality. Further, this manual updates chapters on surgical simulation, teamwork and team training, teleproctoring, mentoring, and error analysis. State-of-the-art and readily accessible, The SAGES Manual of Quality, Outcomes, and Patient Safety, Second Edition will offer physicians strategies to maintain surgical quality in a rapidly changing practice environment the tools they require to succeed.
Translational Surgery covers the principles of evidence-based medicine and applies these principles to the design of translational investigations. The reader will come to fully understand important concepts including case-control studies, prospective cohort studies, randomized trials, and reliability studies. Investigators will benefit from greater confidence in their ability to initiate and execute their own investigations, avoid common pitfalls in surgical research, and know what is needed for collaboration. Further, this title is an indispensable tool in grant writing and funding efforts. The practical, straightforward approach helps the translational research navigate challenging considerations in study design and implementation. The book provides valuable discussions of the critical appraisal of published studies in surgery, allowing the reader to learn how to evaluate the quality of such studies. Thus, they will improve at measuring outcomes; making effective use of all types of evidence in patient care. In short, this practical guidebook will be of interest to every surgeon or surgical researcher who has ever had a good clinical idea, but not the knowledge of how to test it. - Focuses on translational research in Surgery, covering the principles of evidence-based medicine and applying those principles to the design of translational investigations - Provides a practical, straightforward approach to help surgeons and researchers navigate challenging aspects of study design and implementation - Details valuable discussions on the critical appraisal of published studies in Surgery, allowing the reader to effectively use all types of evidence for patient care
- NEW! Robotic-Assisted Surgery boxes highlight a rapidly expanding surgical modality. - NEW! Enhanced Recovery After Surgery boxes promote review of protocols for early recovery for patients undergoing major surgery. - NEW! Patient Engagement Exemplar boxes optimize surgical outcomes by addressing AORN guidelines on the issues of patient care and involvement of the patient's family. - NEW standards and AORN toolkits cover topics ranging from enhanced post-surgical recovery to prevention of pressure ulcers.
This text captures the global standards of bariatric surgery practice at a time of change, excitement, and lots of controversy. The text sheds the light on best practices globally by providing a reliable reference to guide the practicing physician anywhere in the world, and from whatever specialty (surgeon, gastroenterologist or endoscopist) to navigate through the many current options of therapy in this rapidly changing field. The text provides high definition illustrations of these techniques to go with the didactic chapters written by the thought leaders in the field. In addition to the technical part, an important part of the book focuses on quality and outcome measures. The rapid growth and innovations impose the need for strict guidelines and quality control. Thought leaders who created the concept of “Centers of Excellence” shed light on outcome measures and different ways to monitor quality. This will appeal to administrators and different ancillary service providers. The medical section plays a major role as combination therapy seems to be the future. An entire section is dedicated to medical weight management with discussions of the dietary and psychological component of care. The text also provides a dedicated discussion of the metabolic aspect of bariatric surgery, cosmetic surgery and issues of training future surgeons. Thease features differentiate the book from others that only discuss the surgical component, and will broaden the level of interest to all who are involved in the management of this complex disease.
This volume presents a comprehensive, up to date and practical approach to creating an ERAS program for GI surgery. The first sections review the evidence underlying individual elements of ERAS, including evidence from laparoscopic procedures when available or pointing to evidence gaps where more research is required. These are written by experts in the field, including surgeons, anesthesiologists, nurses, and physiotherapists. The format is in the style of a narrative review, with narrative evidence review, and concluding with a table with “take home messages” and 3-5 key references for readers interested in more depth in each topic. Each chapter also addresses management of common complications and patient selection or exceptions. Subsequent chapters address practical concerns, including creation of a pathway team, project management and engaging administration. Experts contribute real-world examples of their pathways for a variety of procedures, including colorectal surgery, bariatric surgery, upper GI and hepatobiliary surgery, enabling the user to have a starting point for creating their own programs. The SAGES Manual of Enhanced Recovery Programs for Gastrointestinal Surgery will be of great value to fully trained surgeons, anesthesiologists, nurses and administrators interested in initiating an ERAS program.
The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE) emphasizes good communication and promotes best practice for the use of electrosurgical, ultrasonic, and microwave energy sources in the operating theatre. This manual describes the basic technology of energy sources in the operating room and demonstrates the correct use and indications of energy sources in clinical practice. It also addresses the potential complications, hazards, and errors in the use of surgical energy sources and evaluates the potential interactions of energy sources with other medical devices. Any healthcare professional who has ever picked up an energy device in the OR such as a “Bovie” , Ultrasonic or bipolar instrument will better understand how it works, when to apply it, and what are the possible hazards and errors in its use. The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE) is the first volume of its kind to provide such guidance and will be of great value to surgeons, anesthesiologists, nurses, endoscopists, and allied health care professionals who use these devices.