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April 27, 2020    New York, USA
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Current and Future Trends in Surgery


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Program reduces narcotic prescriptions after surgery with over-the-counter pain medicine

2020-01-22

Surgeons at Houston Methodist Hospital are stemming the tide of addiction to prescription opioids by managing patients' pain after surgery. By using long-acting local anesthetics at the site of surgery and scheduled non-narcotic pain medicine, they decreased opioid prescriptions from 87% to 10% after surgery. According to the National Institute on Drug Abuse, more than 130 people die every day from opioid overdosing, and a portion of these deaths may be due to the availability of opioids after elective surgery. Up to 10% of patients develop addictions after taking opioids following elective surgery.

Creating the ideal nasal tip contour

2020-02-11

In the Special Communication titled "Nasal Tip Contouring: Anatomic Basis for Management," Dr. Toriumi addresses the complexity of nasal tip contouring and helps rhinoplasty surgeons navigate the many techniques available to them. He discusses the ideal nasal tip contour, options for stabilizing the base of the nose, techniques for reorienting existing tip structures, and shield tip grafting. He also recommends learning as much as possible from each case by following previous patients. In an interview with Dr. Toriumi, led by journal Editor-in-Chief, Dr. John Rhee and titled "Evolution of a Rhinoplasty Master," Dr. Toriumi highlights a key theme over the past 30 years: the use of structural grafting to make the nose stronger and provide a better long-term aesthetic and functional outcome. Dr. Toriumi points out that structure rhinoplasty is neither preservation rhinoplasty nor is it destructive. Instead, the existing structures are supported by adding cartilage grafts. In describing the evolution in tip grafting, he says that shield tip graft can be very useful if used properly. Dr. Toriumi also discusses complex techniques at high execution risk that should be performed by more experienced surgeons. The interview also focuses on future trends in the field.

One in five operations may lead to surprise bills, even when surgeon and hospital are in-network

2020-02-12

On average, that potential surprise bill added up to $2,011, a team from the University of Michigan reports in the new issue of JAMA. That's on top of the nearly $1,800 the average privately insured patient would already owe after their insurance company paid for most of the costs of their operation. All the patients in the study chose a surgeon who accepts their insurance, and had one of seven common, non-emergency operations at an in-network hospital or at an outpatient surgery center. But they still ended up potentially owing large sums to pay other people involved in their operation or their follow-up care. The average potential surprise bill ranged from $86 for medical imaging specialists involved in a hysterectomy, to more than $8,000 for surgical assistants involved in a breast lumpectomy. These out-of-network bills were significantly more common for patients who had complications after surgery. If the patient had an outpatient procedure with an in-network surgeon, but it took place at an ambulatory surgery center that was out-of-network, the potential surprise bill could add up to more than $19,000.

New tool aids patients in selecting a transplant center

2020-02-24

A new website developed by researchers at Hennepin Healthcare Research Institute (HHRI) and the University of Minnesota (UMN) is making it easier for organ transplant candidates to choose which transplant center is right for them. Schaffhausen recently published an article about the new tool entitled "Tool to Aid Patients in Selecting a Liver Transplant Center," in the March issue of Liver Transplantation journal. This article is featured on the front cover of the journal. The Principal Investigator and senior author on the project is Ajay Israni, MD, MS and other researchers and co-author include Warren McKinney, Ph.D. at HHRI. The HHRI team is also working with multiple collaborators at UMN.

Increase seen in melatonin secretion after cataract surgery

2020-03-06

Cataract surgery seems to increase melatonin secretion in adults aged 60 years or older, according to a study published online March 5 in JAMA Ophthalmology. The researchers found that independent of baseline urinary melatonin excretion and potential confounders, mean urinary melatonin excretion was significantly higher in the intervention versus the control groups (adjusted mean difference of creatinine concentration, 0.159 log ng/mg). Comparing the groups that received a clear IOL, concentration of urinary melatonin excretion was higher for the intervention versus the control group; there was no significant difference noted when comparing the groups that received a yellow IOL. There was no significant difference seen in the concentration of mean urinary melatonin excretion for patients in the intervention groups.

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