Vascular Surgery Training Research Articles

Presidential address: One man's odyssey

Presidential address: One man's odyssey

Training of Vascular Surgeons in France: Ten Years of the French College of Vascular Surgery

The French College of Vascular Surgeons serves several functions including the organization of vascular surgery training nationwide, overseeing the practical aspects of institutional training, providing motivation for trainees by creating final exams, and bringing surgeons together to update their knowledge. This article details the results of their programs, the demographic changes in vascular surgical practice over the last ten years, and the problems to be solved in the near future. These challenges include: maintenance of autonomy in the surgical world, enlargement of the fields of action, clarification of indications for vascular procedures, demographic control, and recognition of training programs on the wider, European level.

Construction of internal arteriovenous fistulas for hemodialysis using Inokuchi's vascular stapler.

Using Inokuchi's vascular stapler, arteriovenous fistulas with an end-to-end fashion for hemodialysis were constructed in 80 patients (82 limbs) with chronic renal failure. In 76 patients and 76 limbs (95%) of a total of 80 patients, the fistulas were patent and hemodialysis could be effectively carried out. Use of Inokuchi's vascular stapler facilitated a rapid construction of subcutaneous end-to-end arteriovenous fistulas, and no particular training in vascular surgery was required for the operator. Since the anastomosis was constructed in an end-to-end fashion, complications such as swollen hand, peripheral steal syndrome and cardiac failure were nil.

Training and Certification of Vascular Surgeons

General surgery training can provide a sound basis or even complete training in vascular surgery, but in many instances additional experience may be required. It is hoped that in the future individuals who gain competency in vascular surgery can be recognized by special certification by the American Board of Surgery.

The Pulse Monitor

THE DEVELOPMENT of simple percutaneous arteriographic catheterization techniques, the synthesis of safer contrast media, the ready availability of good angiographic roentgenographic equipment, and the increasingly large number of surgeons with training in vascular surgery have created a situation in which most large hospitals are now expected to have an efficient angiographic department. There has been a resultant marked increase in the utilization of arteriographic procedures throughout the country despite the fact that at present relatively few physicians are thoroughly grounded in all aspects of angiography. Recent large reviews of catheter aortographic procedures^1-4,5showed that, while mortality was very low, there was a significant number of serious nonfatal complications at the site of catheter insertion, such as massive hematomas, uncontrolled bleeding, arterial thromboses, and subintimal dissections, some of which led to permanent disability. The incidence of major arterial thrombosis is usually less than 1% but can be as high as

The pulse monitor. An important safeguard in angiography and arterial catheterization.

THE DEVELOPMENT of simple percutaneous arteriographic catheterization techniques, the synthesis of safer contrast media, the ready availability of good angiographic roentgenographic equipment, and the increasingly large number of surgeons with training in vascular surgery have created a situation in which most large hospitals are now expected to have an efficient angiographic department. There has been a resultant marked increase in the utilization of arteriographic procedures throughout the country despite the fact that at present relatively few physicians are thoroughly grounded in all aspects of angiography. Recent large reviews of catheter aortographic procedures^1-4,5showed that, while mortality was very low, there was a significant number of serious nonfatal complications at the site of catheter insertion, such as massive hematomas, uncontrolled bleeding, arterial thromboses, and subintimal dissections, some of which led to permanent disability. The incidence of major arterial thrombosis is usually less than 1% but can be as high as

Two cases of duodenal ulceration in children

Oncovascular surgery is a new term used to define tumor resection with simultaneous reconstruction of the great vessels when the tumor infiltrates or firmly adheres to such vessels. The benefit of oncovascular surgery has been widely described in patients with hepato-biliary-pancreatic cancers, retroperitoneal soft tissue sarcoma, and in other areas of gynecologic oncology, such as the lateral compartment of the pelvis, retroperitoneum, and hepato-biliary-pancreatic region, with an increase in complete resections and without increasing the morbidity and mortality rates. In the latter decades of the past century, several advances and accumulating scientific evidence led gynecologic oncologists to perform more thorough cytoreductive surgeries that included multivisceral resections. But to our knowledge, published studies on the frequency and relevance of vascular surgery in gynecological oncology are scarce. Gynecologic oncologists still do not receive formal training in vascular surgery and additionally, with the current reduction in experience with pelvic and para-aortic lymphadenectomy, as well as other types of radical abdominal and pelvic surgeries, trainees will encounter fewer vascular injuries and the opportunity to deal with a variety of management types required. Well-organized collaboration between each subspecialty with a multidisciplinary approach and adequate pre-operative planning are pivotal. The aim of this review is to pave the way towards the understanding that patients with suspicion of great vessels9 infiltration or encasement by tumor require personalized and specialized treatment with the need to form an oncovascular surgery team, and that it is necessary for gynecologic oncology surgeons to take a step forward in surgical training.