Latest Updates

Anesthetic Management of Intracranial Aneurysms

Matthew J Hammer, MD, Laura B Hemmer, MD, FASA
    • Endovascular techniques for aneurysm obliteration have increased in popularity. Aneurysm management decisions are best made by a multidisciplinary team, with choice of therapy that considers factors such as the aneurysm’s size, growth, anatomic location, patient’s age, and presence of concomitant intracranial vascular pathologies.
    • Motor-evoked potential monitoring is being increasingly added to the neuromonitoring regimen for intracranial aneurysm clipping. It serves as a real-time monitor of ischemic injury and can impact decision-making in aneurysm surgery.
    • Intraoperative video-angiography is an alternative to the gold-standard method of digital subtraction angiography to assess aneurysm clip placement and surrounding vessel patency. Intraoperative videoangiography most often uses indocyanine green as the dye.
    • Intravenously administered adenosine has emerged both as an alternative to proximal temporary arterial occlusion (such as when proximal temporary arterial occlusion is impractical or unsafe due to small surgical corridors or nearby perforating arteries) and as a rescue maneuver to aid in surgical field visualization during inadvertent intraoperative aneurysm rupture.

Principles and Techniques of Abdominal Access and Physiology of Pneumoperitoneum

Jon C. Gould, MD, FACS, Kathleen Simon, MD
    • Decreasing pain at access incisions
    • Multi-modal pain management, TAPP block, opioid sparing analgesia.
    • Heated, humidified CO2.

Principles and Techniques of Abdominal Access and Physiology of Pneumoperitoneum

Jon C. Gould, MD, FACS, Kathleen Simon, MD
    • Decreasing pain at access incisions
    • Multi-modal pain management, TAPP block, opioid sparing analgesia.
    • Heated, humidified CO2.

Medical Management of Erectile Dysfunction

Laith M Alzweri, MD, MRCS, FECSM, Matthew G Cowper, BS, Andrew T Gabrielson, BA, Wayne J Hellstrom, MD, FACS
    • PDE-5 inhibitors remain the gold-standard first-line treatment for erectile dysfunction.
    • Patients who fail pharmacologic therapy may opt for vacuum-assist device, intracavernosal injections, or intraurethral suppository.
    • New regeneration therapies (stem cell, low-intensity shockwave treatment, platelet-rich plasma) have been shown to reconstitute damaged vasculature and endothelium within the corpora cavernosa in animal models; however, human studies are lacking.

Pediatric Infectious Diarrhea and Dehydration

John W. Martel, MD, PhD, Scott McCorvey, MD, MS
    • National Hospital Ambulatory Medical Care Survey: 2011 emergency department summary tables
    • Volume resuscitation in suspected hemolytic-uremic syndrome
    • Clostridium difficile in the pediatric population
    • Evaluation and management of suspected pediatric dehydration
    • Efficacy of rotavirus vaccine and epidemiology of viral gastroenteritis
    • Probiotics and their role in prevention of infectious diarrhea

Pediatric Infectious Diarrhea and Dehydration

John W. Martel, MD, PhD, Scott McCorvey, MD, MS
    • National Hospital Ambulatory Medical Care Survey: 2011 emergency department summary tables
    • Volume resuscitation in suspected hemolytic-uremic syndrome
    • Clostridium difficile in the pediatric population
    • Evaluation and management of suspected pediatric dehydration
    • Efficacy of rotavirus vaccine and epidemiology of viral gastroenteritis
    • Probiotics and their role in prevention of infectious diarrhea

Transplantation for the General Surgeon: Care of the Transplant Patient

Susanna M Nazarian, MD, PhD
    • Living donor transplantation, including choice of donors, surgical technique, expected graft performance, expected graft and patient survival
    • Immunosuppression, including its main categories, current practice, common side effects and drug interactions
    • Intestinal rehabilitation including its role in limiting intestinal transplantation, surgical techniques

Endoscopic Ultrasonography

Nitkin Kumar, MD, Marvin Ryou, MD
    • Pancreatic necrosis complicates approximately 20% of cases of acute pancreatitis. Traditional treatment has been surgical débridement or percutaneous drainage. Necrotic tissue can mature to form well-defined, discrete collections of walled-off pancreatic necrosis. Endoscopic ultrasonography (EUS)-guided endoscopic necrosectomy is safe and efficacious and should be considered in symptomatic, infected, or especially large collections. A novel EUS-guided lumen-apposing self-expanding metal stent has been developed to facilitate access and drainage.
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