Latest news with #DepartmentofSurgery
Medscape
6 days ago
- General
- Medscape
No Safety Advantage to Emergency Robotic Cholecystectomy
TOPLINE: In acute care settings, robotic-assisted cholecystectomy (RAC) and laparoscopic cholecystectomy (LC) resulted in similar rates of bile duct injury, but RAC was associated with higher rates of major postoperative complications, more frequent drain placement, and longer hospital stays than LC. METHODOLOGY: Although some prior studies have raised concerns about increased bile duct injury with RAC vs LC, their relative safety in acute care surgery remains unclear. Researchers conducted a retrospective cohort analysis using commercial claims and encounter data from 2016 to 2021 to compare outcomes between RAC and LC in acute care surgery. The primary outcome was bile duct injury; secondary outcomes included major postoperative complications, the use of a postoperative drain, length of hospital stay, surgical site infections, and conversion to open surgery. TAKEAWAY: Researchers included 844,428 adults (mean age, 45.6 years; 64.9% women), with 35,037 undergoing RAC and being propensity-matched with an equal number of adults who underwent LC. Adoption of RAC increased from 2.2% in 2016 to 8.2% in 2021. Bile duct injury rates were similar between the groups (P = .54). RAC vs LC was associated with higher rates of major postoperative complications (8.37% vs 5.50%; P < .001), an increased use of postoperative drains (0.63% vs 0.48%; P < .001), and a longer median hospital stay (3 vs 2 days; P < .001). Use of intraoperative cholangiograms was more common in the LC than in the RAC group (P < .001), whereas RAC was associated with fewer surgical site infections than LC (0.04% vs 0.09%; P = .02). Conversion to open surgery was uncommon in both the groups. IN PRACTICE: 'Although these results may partly reflect case complexity and selection bias, they do not suggest a clear advantage of RAC over the standard, established laparoscopic cholecystectomy,' the authors wrote. SOURCE: The study was led by Nathnael Abera Woldehana, MD, MPH, Division of Minimally Invasive Surgery, Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore. It was published online in JAMA Surgery. LIMITATIONS: The retrospective design may have introduced selection bias and unmeasured confounding factors. The study's generalizability is limited to commercially insured populations. Long-term outcomes such as readmissions, quality of life, and cost-effectiveness were not assessed. DISCLOSURES: Some authors reported receiving conference travel/attendance support, consulting fees, grants, advisory board fees, and speaker fees and having other ties with several organizations and pharmaceutical companies. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Business Wire
28-05-2025
- Health
- Business Wire
Resolve Therapeutics and Duke Medical School Initiate Observational Study of Cell-free RNA in Polytrauma Patients
MIAMI--(BUSINESS WIRE)--Resolve Therapeutics, a leader in the emerging field of cell-free nucleic acid therapeutics, today announced a collaboration with the Department of Surgery, Duke University School of Medicine to analyze the role of cell-free RNA (cfRNA) in polytrauma A significant number of trauma patients admitted to the hospital each year suffer from polytrauma, with multiple, life-threatening injuries requiring immediate surgical intervention. Many of these patients experience poor clinical outcomes due to Systemic Inflammatory Response Syndrome (SIRS). The mechanism of SIRS in polytrauma patients is not completely understood but the current view holds that that massive tissue injury results in the release of large amounts of RNA into the blood overwhelming the activity of circulating RNase, which protects cells from the inflammatory effects of cfRNA under normal circumstances. The accumulating cfRNA activates several key mechanisms driving local and systemic inflammation which leads to increased morbidity and mortality. 'Preventing systemic inflammation in polytrauma would be a large step forward in the treatment paradigm for these patients,' said Allan D. Kirk, MD, PhD, Chair of the Department of Surgery at Duke University. Share Working closely with the world's foremost trauma surgeons at Duke University, Resolve and Duke will conduct an observational study to analyze the presence, structure, and drug targeting of cfRNA in a selected population of polytrauma patients. Based on the results of this work, a proof-of-concept clinical trial with RSLV-132 (a fully human, catalytically active, RNase Fc fusion protein) may be undertaken seeking to improve clinical outcomes for polytrauma patients by removing circulating inflammatory nucleic acids. 'We are thrilled to work with the world class physician scientists within the Duke University School of Medicine and are hopeful our work together may lead to an improvement in the outcome for patients with polytrauma,' commented Dr. James Posada chief executive officer of Resolve Therapeutics. 'Duke Surgery offers a unique environment, coupling state of the art patient care with basic research expertise and infrastructure to enable systematic molecular analysis of plasma-borne inflammatory nucleic acids.' 'Preventing systemic inflammation in polytrauma would be a large step forward in the treatment paradigm for these patients,' said Allan D. Kirk, MD, PhD, Chair of the Department of Surgery at Duke University. 'We look forward to the collaboration with Resolve and learning more about the underlying mechanisms of inflammation in critically injured patients,' he added. About RSLV-132 RSLV-132 is a safe, fully-human, non-immunosuppressive, non-immunogenic, biologic drug with a three-week serum half-life. The drug is comprised of catalytically active human RNase fused to an engineered Fc region of human IgG1. It is designed to remain in circulation and digest extracellular pathogenic RNA in diseases where the presence of cfRNA drives the inflammatory process. RSLV-132 has proven safe in five clinical trials and has demonstrated improvement in autoimmune symptoms in phase 2 clinical trials in both systemic lupus erythematosus and Sjogren's syndrome. About Resolve Therapeutics Resolve is a biopharmaceutical company at the forefront of the emerging field of cell-free nucleic acids in disease. We are developing RSLV-132 and RSLV-145 in a broad range of acute and chronic diseases that are driven by cell-free RNA, cell-free DNA, and Neutrophil Extracellular Traps (NETs). For more information or to discuss our programs please visit:
Arab Times
02-05-2025
- Health
- Arab Times
Kuwaiti Surgeon Dr. Waddah Al-Rifai Selected for US-European Exchange Program
KUWAIT CITY, May 2: The American Surgical Association has selected Dr. Waddah Al-Rifai, a prominent Kuwaiti physician and Chair of the Department of Surgery at Creighton University, to participate in the 2025 Scientific Exchange Program with the European Surgical Association. Dr. Al-Rifai is the first surgeon from Kuwait, the Gulf region, and the Arab world to receive this distinction. In remarks to the Kuwait News Agency, Dr. Al-Rifai expressed deep pride in being honored during the 31st annual meeting of the European Society of Surgery, currently taking place in Geneva, Switzerland. The conference opened on Friday and will conclude on Saturday. Dr. Al-Rifai credited the achievement to the unwavering support extended to the medical sector by His Highness the Amir Sheikh Meshaal Al-Ahmad Al-Jaber Al-Sabah, His Highness the Crown Prince Sheikh Sabah Al-Khaled Al-Hamad Al-Sabah, and His Highness the Prime Minister Sheikh Ahmad Al-Abdullah Al-Sabah. He noted that his selection reflects the growing international recognition of Kuwaiti medical expertise and underscores the country's respected status in the global healthcare community. Reaffirming his commitment to serving Kuwait and humanity, Dr. Al-Rifai emphasized the importance of scientific collaboration and knowledge exchange with international medical institutions as a key factor in advancing the nation's healthcare system. He also expressed sincere gratitude to the American Surgical Association for the honor, highlighting his eagerness to contribute meaningfully to the program and to further elevate Kuwait's presence on the international medical stage.
Yahoo
27-02-2025
- Health
- Yahoo
Failing heart saves two more lives in medical first
Three girls with major heart problems are thriving after one received a donor heart and then gave healthy valves from her original heart to two other girls. The 'domino' heart surgeries by a team at Duke Health marked the world's first living mitral valve replacement. Mitral valve replacement in children traditionally uses non-living tissue or mechanical valves, neither of which grow as a child grows. Instead, mitral valve replacement means a series of surgeries and blood thinners as the child outgrows the valve. Those surgeries can be risky and not all patients survive. 'There's not a good valve option for kids,' Dr. Douglas Overbey, assistant professor in the Department of Surgery at Duke University School of Medicine and one of the team members behind the pioneering procedure, said in a news release. 'They all require multiple surgeries, and we know they're going to fail down the road,' he said. 'That's something that's really hard to talk to parents about, knowing that you're going to have to do the same surgery with a new valve, maybe six months later because they're going to outgrow it.' All three of the girls were from North Carolina. Journi Kelly, 11, of Wilson, received the donor heart. She donated one of her original heart's valves to Margaret Van Bruggen, 14, of Charlotte. Then Kensley Frizzel, now 9, of Pembroke, received another valve from Journi's original heart. The mitral valve resides between the left chambers of the heart, serving as a one-way door to keep blood flowing in the right direction. It allows oxygenated blood from the lungs to flow into the ventricle, which is the heart's lower left chamber. The valve closes so that blood doesn't flow back into the left upper chamber, called the left atrium. When things go wrong with the valve, blood can leak backward, called mitral valve regurgitation. When the mitral valve stiffens or fuses together, it narrows and limits blood flow. Either condition can be very serious and the surgery can be risky. According to Duke, Journi had complained of a stomachache, but in the emergency department doctors discovered she was in heart failure. Two days later, she was flown by air ambulance to Duke and placed on the transplant waiting list. Her parents agreed that her old heart could be donated for use in a new procedure that could help other children. It was found that her valve structure was 'serendipitously' a good match for the other two girls. Margaret, a high school freshman, had contracted a bacterial infection that created holes in her mitral valve. The girl, a cross-country runner, was in the hospital when Journi's donor heart made the living valve transplant a possibility. Kensley has spent a lot of her young life in the hospital. She was diagnosed at birth with a genetic disorder called Turner's syndrome and had two operations before she was even two months old. A veteran of long hospital stays, her family was excited to be told that the mitral valve replacement might be the last surgery she would need. 'We were expecting she would need surgery, but we never knew this would be an option,' said Kenan Frizzell, Kensley's father. 'The whole situation is extraordinary, whether you look at it from the standpoint of a scientific breakthrough or the average person's point of view. I can't imagine all the coordination that's needed for something like this to take place, but as one of the families that benefited, we can't be anything other than grateful.' The mitral valve is inside and toward the back of the heart, so it's not easy to access. And the surgery for that reason can be challenging. The Duke team said it carries risks that are common with heart surgery. The mitral valve also has an odd, parachute-like shape that is not easy to sew into the heart. The news release called the living mitral valve replacement a type of 'partial heart transplant,' which Duke pioneered in 2022, providing functioning valves and arteries that in the case of children grow with the patient. 'Partial heart transplant was studied in Duke research labs before the procedure was done, and research shows the living valves do continue to grow. Duke has now performed 20 partial heart transplants under the guidance of the FDA,' per the release. That first 2022 surgery was hailed as ushering in a 'domino' heart transplant, where one heart saves more than one person. The Duke team said not all hearts donated are suitable for transplant, but many of those that are not suitable to operate as a full heart could be used for valves, boosting the number of people who receive life-saving procedures. 'To think that the lives of three girls could be saved after one full heart donation is amazing,' said Dr. Joseph Turek, Duke's chief of pediatric cardiac surgery. He performed the procedure with a large team after research in the lab said it was a viable option.
