Surgical Experience In Patients Research Articles

ADVANCES IN LAPAROSCOPIC SURGERY

Laparoscopic surgery has established itself as an innovative and effective approach to treating acute abdominal diseases, revolutionizing traditional surgical practices. With the advancement of medical technologies and the growing demand for less invasive procedures, laparoscopy offers significant advantages, such as reduced postoperative pain, shorter recovery time and lower complication rates. This paper explores recent advances in the laparoscopic technique, highlighting its role in the future of minimally invasive surgery. This paper sets out to explore the main advances in laparoscopic surgery, its applications in the treatment of acute abdominal diseases and the future prospects of this minimally invasive approach, discussing how these developments can positively impact surgical practice and the patient experience. This is a literature review with a qualitative approach, using the PubMed, Google Scholar and Scielo databases. To refine the search, the health descriptors “laparoscopic surgery”, “minimally invasive surgery”, “surgical training”, and “inequalities in surgical access” were applied, with a time frame between 2020 and 2022. The methodology adopted for this analysis involves a comprehensive literature review of recent scientific articles, systematic reviews and clinical guidelines. The study examines innovations such as the use of robotics, advanced surgical instruments and improved visualization techniques, which have broadened the indications for laparoscopic surgery. In addition, the research highlights the importance of continuing education for surgeons, emphasizing the need for specific skills to successfully perform laparoscopic procedures. The data shows that laparoscopy not only improves clinical outcomes, but also promotes a more comfortable surgical experience for patients. Therefore, advances in laparoscopic surgery represent a significant milestone in the approach to acute abdominal diseases, establishing a promising future for minimally invasive surgery. The integration of new technologies and techniques, together with the proper training of professionals, is crucial to maximizing the benefits of this approach. Laparoscopy not only transforms surgical treatment, but also redefines patients’ expectations regarding recovery and quality of life. Continued development in this field promises not only better clinical results, but also a positive impact on the efficiency of health services.

Experiences of older surgical patients and care partners during COVID-19: Lessons for future care.

Experiences of older surgical patients and care partners during COVID-19: Lessons for future care.

YouTube Videos Provide Low-Quality Educational Content About the Anterolateral Ligament of the Knee

PurposeThe purpose of the current study is to evaluate the reliability and quality of the educational content of YouTube videos about anterolateral ligament (ALL). MethodsA standard search was performed on the YouTube database. All English-language videos were included for analysis. Video reliability was assessed with the use of the DISCERN tool, the Journal of American Medical Association (JAMA) benchmark criteria, and the Global Quality Score (GQS). Data regarding the duration of the videos, the date of publication, and the number of likes and views were collected. Furthermore, videos were categorized based on video source (health professionals, company, private user), the type of information (surgical technique, overview, anatomy, radiology and patient experience) and video content (education, patient experience/testimony). ResultsA total of 94 videos were included in the analysis. Eighty-eight (93.6%) videos were published by health professionals, while 4 (4.3%) were published by companies and 2 (2.1%) were published by private users. Most of the videos were about surgical technique (57.4%), and almost all the videos (98.9%) had an educational aim except one that reported a patient experience (1.1%). The mean length of the videos was 648.4±973.5 seconds, and the mean online period was 34.5±27.0 months. The mean DISCERN score, JAMA score and GQS were 32.9±15.9, 1.5±0.9 and 2.3±1.0, respectively. Videos that provided an overview of the ALL were the best in terms of all quality scores and were significantly higher quality than videos about surgical technique and anatomy, radiology and patient experience for all the scores (p<0.001). No difference was found between surgical technique and anatomy, radiology and patient experience (DISCERN score p>0.99; JAMA score: p=0.839; GQS: p>0.99). ConclusionsThe educational content of YouTube videos about the anterolateral ligament of the knee showed low quality and validity based on the DISCERN, JAMA and GQS scores.

The Causes of Intraoperative Pain among Elective Caesarean Section Patients under Sub-Arachnoid Block at the Tamale Teaching Hospital

Background: Intraoperative pain is a possible complication of neuraxial anaesthesia for caesarean delivery. Possible causes of intraoperative pain following caesarean section under spinal anaesthesia have been proposed. The potential consequences include inadequate anaesthesia, nerve injury during needle insertion, manipulation of internal organs during surgery, and psychological factors such as anxiety and fear. This study was conducted to assess the causes of intraoperative pain among patients undergoing elective caesarean section under sub-arachnoid block at the Tamale Teaching Hospital. Methods: A descriptive cross-sectional research design was employed in this study. A total of 55 women who have had elective caesarean section under sub-arachnoid block were selected for the study. Data was collected using a structured questionnaire and analysed with the SPSS. Results: Findings from the study showed a high incidence of intraoperative pain among women during elective caesarean section under sub-arachnoid block (96.4%). These were mainly sharp and aching pain. However, the levels of the pain experienced intraoperative were mild (52.7%) and moderate (43.6%). Increased length of time spent during surgery and ineffectiveness of medications/ injections given to prevent pain were the main factors contributing to intraoperative pain among patients during elective caesarean section under sub-arachnoid block. Conclusions: The study found a substantial incidence of intraoperative pain during caesarean delivery. To mitigate intraoperative discomfort and enhance the overall surgical experience for patients having elective CS, it is crucial to address these issues by employing optimised anaesthesia techniques, implementing effective pain management measures, and utilising preoperative psychological therapies.

A Culturally Adapted Perioperative Mental Health Intervention for Older Black Surgical Patients

ObjectivesPerioperative mental health of older Black surgical patients is associated with poor surgical outcomes; however, evidence-based perioperative interventions are lacking. Our two study objectives included: first, examine factors affecting perioperative care experiences of older Black surgical patients with mental health problems, and second, ascertain design and implementation requirements for a culturally-adapted perioperative mental health intervention. Design Setting and ParticipantsWe conducted six focus groups with older Black patients (n = 15; ≥50 years; surgery within the past 5 years and/or interest in mental health research; history of distress, anxiety, or depression coping with surgery/hospitalization/) from a large academic medical center. We engaged study partners, including interventionists and community members, to gather insights on intervention and implementation needs. We followed a hybrid inductive-deductive thematic approach using open coding and the National Institute on Minority Health and Health Disparities Research Framework. ResultsPatients reported that their psychological well-being and long-term mental health outcomes were not appropriately considered during perioperative care. Perceived stressors included interpersonal and structural barriers to using mental healthcare services, clinician treatment biases and ageism in care, and lack of healthcare professional connections/resources. Patients utilized various coping strategies, including talk therapy, faith/spirituality, and family and friends. ConclusionThis study offers valuable insights into the experiences of older Black surgical patients and the critical elements for developing a personalized perioperative mental health intervention to support their well-being before, during, and after surgery. Our findings demonstrated a need for a patient-centered and culturally adapted intervention targeting the individual/behavioral and interpersonal levels. Informed by the cultural adaptation framework, we propose a multi-component intervention that integrates psychological and pharmacological components.

Complications of Pelvic Prolapse Surgery Using Mesh: A Systematic Review.

Pelvic organ prolapse (POP) is a public health problem that influences millions of women around the globe, and it has a significant impact on the quality of life. From the FDA statement regarding the complications of using mesh implants in POP surgery to studies that have shown the benefits and side effects, we conducted a systematic review investigating the complications associated with surgical mesh implantation for POP repair. Relevant studies were identified through a comprehensive search of scientific databases. Studies evaluating the use of mesh in POP surgery and reporting on associated complications were included. Among 2816 studies, 28 studies met the research criteria, with a total number of 8958 patients, revealing that in laparoscopic mesh surgery, the rate of mesh exposure was lower compared to vaginal mesh surgery, among other complications. Laparoscopic mesh surgery is superior as a long-term approach for POP repair compared to vaginal mesh surgery, offering lower complication rates and potentially better anatomical success. However, vaginal mesh surgery remains a valuable option for patients who are unsuitable for laparoscopy due to specific factors. Future research should explore alternative techniques, like pectopexy with or without mesh, to further improve surgical outcomes and patient experience.

Adapting the World Health Organization's Surgical Safety Checklist to High-Income Settings: A Hybrid Effectiveness-Implementation Trial Protocol.

The proposed study aims to assess users' perceptions of a surgical safety checklist (SSC) reimplementation toolkit and its impact on SSC attitudes and operating room (OR) culture, meaningful checklist use, measures of surgical safety, and OR efficiency at 3 different hospital sites. The High-Performance Checklist toolkit (toolkit) assists surgical teams in modifying and implementing or reimplementing the World Health Organization's SSC. Through the explore, prepare, implement, and sustain implementation framework, the toolkit provides a process and set of tools to facilitate surgical teams' modification, implementation, training on, and evaluation of the SSC. A pre-post intervention design will be used to assess the impact of the modified SSC on surgical processes, team culture, patient experience, and safety. This mixed-methods study includes quantitative and qualitative data derived from surveys, semi-structured interviews, patient focus groups, and SSC performance observations. Additionally, patient outcome and OR efficiency data will be collected from the study sites' health surveillance systems. Statistical data will be analyzed using Statistical Product and Service Solutions, while qualitative data will be analyzed thematically using NVivo. Furthermore, interview data will be analyzed using the Consolidated Framework for Implementation Research and reach, effectiveness, adoption, implementation, maintenance implementation frameworks. The toolkit will be introduced at 3 diverse surgical sites in Alberta, Canada: an urban hospital, university hospital, and small regional hospital. We anticipate the results of this study will optimize SSC usage at the participating surgical sites, help shape and refine the toolkit, and improve its usability and application at future sites.

YouTube content on shoulder arthroplasty is highly viewed but is of poor educational quality

BackgroundYouTube videos on shoulder arthroplasty cover a broad range of topics, from patient testimonials to surgical techniques. Inherent to this platform, there are no quality control measures to monitor this content. The purpose of this study is to evaluate the quality and popularity of videos on shoulder arthroplasty on YouTube, using both previously described scores and a proposed novel shoulder arthroplasty–specific score assessing educational content. MethodsA search was performed using the keywords “shoulder arthroplasty” and “shoulder replacement” on YouTube. Videos were sorted by relevance and the first 50 videos for each keyword were included in a playlist. The videos in the playlist were then sorted by popularity and the first 50 were included for analysis. Videos in a non-English language, duplicate videos, or those lacking audio were excluded. Video source, content, time since upload, duration, like and dislike count, were inputted for analysis. The view ratio and video power index were used to assess for popularity. Quality, reliability and educational content were evaluated with the Global Quality Score (GQS), Journal of the American Medical Association (JAMA), and the novel Shoulder Arthroplasty Video Content (SAVC) score, respectively. ResultsThe 50 videos had an average of 285,375 views and a mean duration of 10.8 minutes. Video content was comprised of primarily surgical technique (46%) and patient experience (44%), with most of the videos uploaded from university-affiliated physicians (30%), non-affiliated physicians (28%), and medical (i.e., animations from health websites) (26%) sources. Mean GQS (i.e., quality) and JAMA (i.e., reliability) scores for all videos were 3.2 ± 1.2 out of 5 and 2.4 ± 1.4 out of 4, respectively. Median GQS was comparable across sources, content, and procedure type. Although median JAMA scores were similar among procedure and content type, academic and medical sources showed significantly higher scores among video source categories (P = .04). The mean SAVC score was 19.5 ± 10.7 out of 45 possible points. While there was no significant difference in SAVC scores when categorized by procedure type, a significant difference was observed when assessed by source (P = .02) and content (P = .01). Specifically, medical sources had the highest median score for video source and patient experience for content. ConclusionShoulder arthroplasty videos on YouTube reach a considerable audience, but the educational content and reliability are low. Understanding this can help caution patients on the limitations of educational content on YouTube.

Quality of YouTube Videos Regarding Anterior Cruciate Ligament Reconstruction Using Quadriceps Tendon Autograft Is Unsatisfactory

PurposeThis study aimed to assess the validity and informational value of teaching material regarding anterior cruciate ligament reconstruction (ACL-R) using quadriceps tendon (QT) autograft provided on the YouTubeTM video platform. MethodsAn extensive systematic search of the YouTubeTM video platform was performed, and all videos that met the criteria were included in the analysis. The analysis of the video content was performed using the DISCERN instrument, Journal of American Medical Association (JAMA) benchmark criteria and Global Quality Score (GQS). The duration of the videos, the date of publication, and the number of likes and views were recorded. Furthermore, videos were categorized based on the source (physicians, companies, patients), the subject (surgical technique, patient experience and overview [overview videos were videos in which multiple aspects were analyzed]) and the type of content (educational or subjective patient experience). ResultsA total of 88 videos were included in the analysis. Seventy-one (80.7%) videos were published by physicians, 15 (17.0%) by patients and 2 (2.3%) by companies. The majority of the videos described various surgical techniques (59 – 67.0%), 80.7% of the videos (72 – 81.8%) had an educational nature, and the remaining 18.2% described patient experiences. The mean length of the videos was 8.21 ±7.88 minutes. The mean number of views was 3988.51 ±9792.98 (range: 9-56047), while the mean numbers of comments and likes were 30.07±70.07 (range: 0-493) and 4.48 ±14.22 (range: 0-82), respectively. The mean DISCERN score, JAMA score, and GQS were 27.43 ±11.56 (95% CI: 25.01–29.85; range: 17-68), 1.22 ±0.85 (95% CI: 1.04–1.40; range: 0-3), and 1.82 ±0.93 (95% CI: 1.63–2.01; range: 1-4), respectively. For all scores, videos published by physicians had higher quality (DISCERN score, JAMA score, and GQS) (p<0.05). Among all of the analyzed videos, overview videos were of the highest quality (p<0.05). ConclusionsYouTube™ is a fast and open-access source of mass information. The overall quality of the videos on ACL reconstruction performed using QT autograft was unsatisfactory, demonstrating low educational quality and reliability. Currently, YouTube™ cannot be recommended as a reliable source of information on ACL reconstruction with the quadriceps tendon.

Pulmonary valve replacement-A 10-year single-center surgical experience in ACHD patients.

Large-scale analyses of surgical outcomes after surgical pulmonary valve replacement (sPVR) as part of re-do surgery in adults with congenital heart disease (ACHD) are rare. Therefore, we present our outcomes of sPVR in ACHD patients over the last decade and demonstrate our standardized surgical approach. All ACHD patients who underwent sPVR between January 2013 and August 2022 were included. Primary diagnoses, peri-operative data, post-operative echocardiography, pre- and post-operative RV MRI and in-hospital mortality were examined. Pre- and postoperative MRI parameters were compared using paired testing. Standardized surgery was documented. Normality of continuous variables was tested using Shapiro-Wilk test. 79 patients (male 59.5% (n = 47), 71 re-operations (89.9%)) at a median age of 41.7 (52.2-28.8) years were included. Main underlying disease was Tetralogy of Fallot (TOF; n = 47, 59.5%). After removal of degenerated valve/conduit parts, right ventricular outflow tract (RVOT) patch augmentation and implantation of a larger stented bioprosthesis (25mm in 78.5%) were conducted. In 57% of cases, concomitant surgery was performed (mainly tricuspid valve surgery: n = 28, 35.4%). 25 patients (31.6%) were operated with beating heart technique. Echocardiographic outcomes showed no moderate or severe insufficiency (median Vmax of 2 m/s (2.3-1.77 m/s)) upon discharge. Available MRI data showed significantly lower indexed RV-EDV (p = 0.0006) and RV-ESV (P = 0.0017) after surgery. In-hospital mortality was 5.1% (n = 4). SPVR is a safe therapeutic option with low surgical risk and satisfying post-operative results. It can serve as a solid therapeutic option for patients who need future valve-in-valve interventions.

Low profile posterior lumbar-sacral interbody fusion for lumbosacral degenerative diseases: a technical note

BackgroundThe purpose of this study was to report our surgical experience in patients with lumbosacral degenerative diseases who underwent posterior decompression and interbody fusion fixed with cortical bone trajectory screw and sacral alar screw, which is known as low-profile posterior lumbosacral interbody fusion (LP-PLSIF).MethodsPatients with lumbosacral degenerative disease who underwent LP-PLSIF and traditional PLSIF (control group) internally fixed with pedicle screws were included retrospectively. Patients’ demographic data, operative parameters, and perioperative complications were recorded and analyzed.ResultsA total of 18 patients were enrolled in this study, which included 9 patients (5 male and 4 female) who underwent LP-PLSIF, and 9 patients (4 male and 5 female) who underwent traditional PLSIF. There wasn’t a significant difference in the average age between the two groups, 56.78 ± 10.92 years in the LP-PLSIF group and 60.22 ± 8.21 years in the PLSIF group (p = 0.460). The bone mineral density (BMD) of the two groups of patients were -2.00 ± 0.26 T and -2.13 ± 0.19 T, respectively (P = 0.239). The mean postoperative follow-up time was 12.7 months (range, 12–14 months). The mean operation time was 142.78 ± 11.21 min and 156.11 ± 13.41 min in the LP-PLSIF group and PLSIF group respectively (P < 0.05). The average blood loss was 137.78 ± 37.09 ml in the LP-PLSIF group, and 150.00 ± 27.84 ml in the PLSIF group (P = 0.441). The average postoperative drainage was 85.56 ± 37.45 ml and 122.22 ± 22.24 ml in the LP-PLSIF group and control group respectively (P < 0.05). Patients in the LP-PLSIF group had shorter incision length compared with the control group, 61.44 ± 10.56 mm vs. 74.56 ± 10.22 mm (P < 0.05). The average length of hospitalization of 11.33 ± 2.92 days in the LP-PLSIF group, and 11.11 ± 1.62 days in the PLSIF group (p = 0.844). All patients had significant improvement in VAS pain score, ODI, and JOA evaluation. However, patients in the LP-PLSIF group had better improvement in terms of VAS back pain and ODI in the short term after the operation. There were no neurological complications or wound infection. The fusion rate at the last follow-up was 100% (9 of 9) in the LP-PLSIF group, and 88.89% (8 of 9) in the control group based on CT scans. 1 patient in the control group had asymptomatic sacral pedicle screw loosening.ConclusionsLP-PLSIF is a safe and effective surgical technique for patients with lumbosacral degenerative disease, which has the potential strength of less invasive and better clinical improvement.

Watching a movie or listening to music is effective in managing perioperative anxiety and pain: a randomised controlled trial

PurposeDespite the use of perioperative anxiolytics and pain medication, surgery can be a stressful and painful experience. Providing patients with distractions using video and/or audio tools in addition to medication may be helpful. To date, no studies have compared different distraction modalities in a same-day surgical setting in adults. This study aims to determine whether audio-visual distraction with video glasses (AVD) is more effective in reducing anxiety and pain compared to audio distraction (AD) in conscious patients undergoing orthopaedic surgery. It was hypothesised that AVD, being the more immersive modality, would be more effective than AD on the outcome parameters.MethodsFifty patients undergoing orthopaedic surgery with local and/or regional anaesthesia in a clinical day-care setting were randomly assigned to receive either fixed-scenery AVD or patient-choice AD with music. Primary outcome was anxiety, as measured by the Dutch version of the Spielberger State–Trait Anxiety Inventory-6 (STAI-6) prior to and 15 min after the intervention. Secondary outcomes were pain (Numeric Rating Scale Pain [NRS-P]), systolic and diastolic blood pressure, heart rate and patient satisfaction.ResultsWithin each group, there was a significant reduction in anxiety (p = 0.028 for AVD, p < 0.001 for AD). In contrast to our hypothesis, listening to music without watching a video (AD group) reduced anxiety significantly more than experiencing full AVD (p = 0.018). The mean pain score did not change significantly within either user group, nor did pain scores differ between user groups.ConclusionIn conscious patients undergoing surgery, watching a movie (using video glasses and a headphone set) and listening to music (using only a headphone set) are able to significantly reduce anxiety. AVD, although believed to provide higher levels of distraction, did not prove to be superior to AD. The clinical relevance of this study highlights the potential benefits of AVD or AD modalities in improving the surgical experience for conscious patients. Further research is required to examine the influence of freedom of choice in content on the aforementioned outcomes. To estimate the true value of higher immersion levels, different distraction modalities (e.g. AVD versus virtual reality) featuring the exact same scenery or content need to be compared.Level of evidenceLevel I.

Effects of aprepitant on post-operative nausea and vomiting in patients with congenital heart disease undergoing cardiac surgery or catheterization procedures: a retrospective study with subjects as their own historical control

IntroductionFor patients undergoing cardiac surgery and catheterization procedures, severe post-operative nausea and vomiting (PONV) can occur despite standard anti-emetic interventions. Aprepitant, a neurokinin-1 (NK-1) receptor blocker, is safe and effective at preventing PONV resistant to standard therapies.MethodsPatients with a history of severe PONV presenting for cardiac surgery or catheterization procedures from January 1, 2018 to January 6, 2021 were identified. After pharmacist approval, patients received aprepitant pre-operatively (Dose: 80 mg for weight &amp;gt;50 kg, 40 mg for weight 30–50 kg). A retrospective chart review was performed. Primary outcomes of the incidence of PONV and PONV-related complications were evaluated.ResultsSeventeen patients were included with a mean age of 16.0 years at the time of their initial procedure, which acted as the “control” procedure, and 17.5 years when they received aprepitant. After the control procedure 64.7% of patients required rescue anti-emetics. When this group of patients received aprepitant pre-operatively at their subsequent procedure, only 17.6% required rescue medication (p = 0.005). Similarly, 64.7% of patients suffered at least one PONV-related complication after the control procedure. With aprepitant use pre-operatively, 5.9% of the same patients experienced a PONV-complication (p = 0.0003). Specifically, unplanned ICU admission due to severe PONV after catheterization procedures decreased from 55.6% (5/9) in the control group to 0 after these patients were treated pre-emptively with aprepitant (p = 0.01). For surgical patients, there were significant decreases in PONV-related complications including delayed oral intake and delayed ambulation (p = 0.04) in the aprepitant group compared to the control group.DiscussionThis small, retrospective study supports the conclusion that preoperative aprepitant administration in patients undergoing cardiac catheterization or cardiac surgery with a history of congenital heart disease and severe PONV significantly reduces the incidence of PONV and PONV-related complications. Decreasing these complications will likely improve the surgical experience for patients and families while also decreasing hospital costs and improving efficiency.

Surgical initial experience in patients with COVID-19

Surgical initial experience in patients with COVID-19

A ten-year surgical experience in patients of Tessier No.0 cleft with a bifid nose.

Tessier No.0 cleft with a bifid nose is a rare malformation. Reconstruction of the nose is essential for children/adults to correct facial cosmetic defects and contribute to developing patients' mental health. The aim of the study was to present the 10-year clinical results using local flaps or expanded forehead flaps in bifid nose patients. A retrospective review was performed between January of 2010 and August of 2021 in our department. Sex, age at surgery, associated anomalies, and type of operation were reviewed. A total of 33 patients were retained. The median duration of follow-up was 5.5 years. Fourteen patients underwent multi-stage nasal reconstruction using expanded forehead flap with costal cartilage as a framework, and 16 patients were operated with local skin flap with silicone while the other three were operated with local skin flap with costal cartilage. There were six cases (18.18%) of complications in our study. During follow-up, 28 patients (84.85%) had satisfactory outcomes, four patients (12.12%) had partially satisfactory results, and one patient (3.03%) had an unsatisfactory outcome. Using local skin flap with silicone or costal cartilage rhinoplasty and nasal reconstruction using expanded forehead flap with costal cartilage for patients with a bifid nose of Tessier No.0 cleft showed that it was safe and effective, and had satisfying results in the long-term follow-up.

Embracing robotic surgery in low- and middle-income countries: Potential benefits, challenges, and scope in the future

Robotic surgery has applications in many medical specialties, including urology, general surgery, and surgical oncology. In the context of a widespread resource and personnel shortage in Low- and Middle-Income Countries (LMICs), the use of robotics in surgery may help to reduce physician burnout, surgical site infections, and hospital stays. However, a lack of haptic feedback and potential socioeconomic factors such as high implementation costs and a lack of trained personnel may limit its accessibility and application. Specific improvements focused on improved financial and technical support to LMICs can help improve access and have the potential to transform the surgical experience for both surgeons and patients in LMICs. This review focuses on the evolution of robotic surgery, with an emphasis on challenges and recommendations to facilitate wider implementation and improved patient outcomes.

Application of multimodal identification technology in the innovative management operation department.

BackgroundThe optimization of surgical procedures and the management of surgical quality and safety have become the focus of attention of hospital managers. The application of multimodal identification technology in the innovative management mode of hospital operating department has made remarkable progress.MethodsTo investigate the effect of the upgraded multimodal identification technology on the innovative management of the operating department, 2,280 cases of laparoscopic surgery using traditional surgical management procedures from January to December 2019 before the management upgrade were set as the control group, and 2,350 laparoscopic surgeries with the upgraded multimodal identification management process from January to December 2020 were selected as the experimental group. The operating efficiency, material management efficiency, and patient experience and satisfaction of the two groups were investigated and compared.ResultsCompared with traditional procedures, the upgraded multimodal surgical management system significantly improves the efficiency of laparoscopic surgery and reduces surgical consumption and costs. In addition, the multimodal surgical information identification system significantly improves the surgical experience for patients undergoing laparoscopic surgery.ConclusionApplication of multimodal identification technology improves the innovative management of operation department compared with traditional surgery management procedure.

Upper Airway Stimulation in Patients with Obstructive Sleep Apnea: Long-Term Surgical Success, Respiratory Outcomes, and Patient Experience.

Introduction Upper airway stimulation (UAS) with electric activation of the hypoglossal nerve has emerged as a promising treatment for patients with moderate-to-severe obstructive sleep apnea. Objective To retrospectively analyze objective and subjective outcome measures after long-term follow-up in obstructive sleep apnea patients receiving upper airway stimulation. Methods An observational retrospective single-center cohort study including a consecutive series of patients diagnosed with obstructive sleep apnea receiving upper airway stimulation. Results Twenty-five patients were included. The total median apnea-hypopnea index (AHI) significantly decreased from 37.4 to 8.7 events per hour at the 12-month follow-up ( p < 0.001). The surgical success rate was 96%. Adverse events were reported by 28% of the patients. Conclusion Upper airway stimulation is an effective and safe treatment for obstructive sleep apnea in patients with continuous positive airway pressure (CPAP) failure or intolerance. However, it is possible that the existing in and exclusion criteria for UAS therapy in the Netherlands have positively influenced our results.

Informed Consent: The Surgical Patient's Experience in a Tertiary Hospital in Northwest Nigeria

Background: Obtaining informed consent (IC) before a surgical procedure is the cornerstone of medical practice. The practice of IC continues to evolve as litigations increase. Most studies on patients' perspectives of IC are either old or were done in southern Nigeria. This study assessed the surgical patients' IC experience in a tertiary hospital in northwest Nigeria.&#x0D; Methods: This cross-sectional study assessed 244 consecutive patients who had elective surgeries in surgical departments of a tertiary hospital. Pretested questionnaires were used to collect data regarding their perception of the meaning of IC, the process of obtaining it, satisfaction with how it was obtained, and factors associated with satisfaction on how consent was obtained.&#x0D; Results: Most were females (61.9%); their mean age was 34.8±14.3 years; 52.9% and 61.9% of respondents did not believe that IC enables patient-clinician shared decision-making or patient's self-decision making, respectively. Most were allowed to ask questions (83.2%), received information on the surgical procedure (91.4%), diagnosis (97.9%); however, 38.5% and 48.8% did not receive information about surgical procedures' immediate and long-term complications, respectively. Surgical procedure explanation was mostly provided by Resident Doctors (53.7%). Most (88.9%) were satisfied with how IC was obtained; satisfaction was associated with being allowed to ask questions, receiving explanations on diagnosis, surgical-procedure, complications of surgery, available alternative treatments, and when the resident/ consultants gave the explanation (all P&lt;0.05).&#x0D; Conclusion: Deficiencies exist in the process of getting IC. Satisfaction with this process was high though associated with following the recommended strategies. Improving the IC process will require appropriate interventions in this and similar settings.&#x0D; Author&#x0D; B A Grema 1, S T Tanimu 1, G C Michael 1, I Aliyu 2, S A Aji 3, I U Takai 4, A I Sulaiman 4

Abstract P4-10-18: The effects of preoperative personalized music therapy associated with the patient-doctor relationship and surgical experience of patients with breast cancer (MARS)

Abstract Background. It is well known through several studies that listening to music can reduce the anxiety of patients. However, most of the previous studies focused only on the psychological effects of patients and some physiological effects such as blood pressure, pain. Moreover, previous studies played music that is not related to personal preferences. The purpose of this study is to investigate whether reducing the patient's anxiety through music selected by patients can improve the patient's surgical experience and the relationship between the patient and doctor. Methods. We randomly assigned 304 breast cancer patients who underwent surgery between September 2020 to April 2021 into a music therapy group(MG) and a control group(CG). Among them, 290 people completed the study. MG (n = 150) listened to the patient's chosen music after entering the operating room until induction of anesthesia, while CG (n = 140) wore earmuffs for noise block in the operating room instead of music. All patients measured anxiety scores over time by numeric rating scale. Treatment satisfaction and patient-doctor depth of relationship scale(PDDRS) were also assessed after surgery. In addition, surgical satisfaction and intimacy with patients were evaluated in the surgeon. Result. The anxiety scores immediately after entering the operating room were not significantly different between the two groups(MG: 4.62 ± 2.44, CG: 4.61 ± 2.45, p = .984). However, the anxiety levels before anesthesia induction of MG patients was 3.36 ± 2.32, which was significantly lower than that of CG patients (3.90 ± 2.26) (p = .047). There was no difference between the groups in PDDRS evaluated for patients after surgery (MG: 26.25 ± 5.529, CG: 25.56 ± 5.918, p = .338) while the degree of intimacy with the patient stated by the surgeon was significantly higher in MG (MG: 7.59 ± 0.89, CG: 7.30 ± 1.05, p = .013). Satisfaction with treatment experience of patients was 18.01 ± 1.78 in MG, which was significantly higher than 17.65 ± 1.59 in CG (p = .040). Especially among the detailed items, the experience in the operating room was evaluated more positively in MG as 4.21 ± 0.79 than 3.91 ± 0.78 in CG (p = .001). The difference in the anxiety-reducing effect of music therapy in the subgroup without surgery history was larger than with a history of surgery, but there was no statistical significance. Similarly, the difference in the anxiety reduction effect in the subgroup with low preoperative anxiety level was greater than that in the subgroup with high anxiety, but this was also not statistically significant (Table 1). People evaluated the experience of surgery more positively as the degree of anxiety reduction in the operating room was greater (Spearman's correlation coefficients = -0.124, p = .035). Conclusion. Personalized selected music in the operating room before anesthesia can effectively lower the patient's anxiety and has the potential to positively change the patient’s satisfaction with surgery. Patients with no surgical history, low pre-operative anxiety can more benefit from personalized music therapy. It is expected to create an opportunity for the patient with breast cancer who anticipate receiving surgery to improve their compliance to treatment by strengthening intimacy with the surgeon. Table 1.Subgroup analysis for anxiety-reducing effect of music in operating roomGroupNMean ± SDDifference between groupP value between groupP value for interactionOverallCG140-0.71±1.560.55.005MG150-1.26±1.68Surgical historyNoCG53-0.38 ± 1.690.75.012.428MG67-1.13 ± 1.49YesCG87-0.92 ± 1.450.44.076MG83-1.36 ± 1.83Pre-Op. GAD-7&amp;lt; 5 pointsCG85-0.55 ± 1.470.73.003.215MG91-1.28 ± 1.57≥5 pointsCG55-0.97 ± 1.670.25.416MG59-1.22 ± 1.86 Citation Format: Yohan Joo, Seockhoon Chung, Seonok Kim, Saebyeol Lee, Sei-Hyun Ahn, Jongwon Lee, BeomSeok Ko, Jisun Kim, Il Yong Chung, Byung Ho Son, Hee Jeong Kim. The effects of preoperative personalized music therapy associated with the patient-doctor relationship and surgical experience of patients with breast cancer (MARS) [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-10-18.