See One, Do One, teach one - Measuring the Learning Curve.

One of the possible victims of public reporting of surgical outcomes of individual surgeons is Surgical Innovation.  When a surgeon is under scrutiny, he dare not innovate lest he fails. Learning a new technique means that initially the operative outcome will not be as good as when the surgery is performed by a surgeon already experienced in this new technique. But if the new technique carries potential advantages, it must be disseminated. So how is this quandary solved? How does a surgeon get over this so called learning curve? This paper by German surgeons on the training of minimally invasive mitral heart valve surgery turns the measuring of the learning curve into a quasi science. There are recognised ways of getting over the learning curve without harming or disadvantaging  patients - using simulation and operating with experienced 'buddies' to start with (so called buddy system) are 2 commonly used. Measuring the learning curve and knowing when a surgeon is ready to fly solo is therefore of crucial importance - which is why this paper from Leipzig is worthy of mention. 

Should we All have a Robot?

JAMA Network | JAMA | Comparative Effectiveness Research on Robotic SurgeryComparative Effectiveness and Robotic Surgery
An interesting leader in JAMA this week about the true usefulness and cost effectiveness of robotic surgery.

Dogs today, Old biddies tomorrow?

One of the commonest causes of deaths in dogs is heart failure due to mitral valve regurgitation.  Not sure how successful an open heart operation using cardiopulmonary bypass could be in dogs. However there is a solution for those rich owners who want their dog to live forever.
I have come across this video of a device that can be used to correct the incompetence.
Only in America - however I suppose if proof of concept is obtained in dogs and the device lasts a few years in situ why stop there - I suspect that Mitral Seal for Humans will soon emerge.

BIONIC SURGEONS

I saw this recently on the BBC and thought what if 2 prostheses like these could be miniaturized and attached to the arms of a surgeon - hey presto  - no more big painful chest cracking incisions and expensive long stays in hospital!
Remember you read this here first.

QUANTUM LEAP AND LAPAROSCOPY SKILLS

Last year, I was awarded the Marian & Cristina Ionescu scholarship from the Society for Cardiothoracic Surgery of GB and Ireland. This scholarship is awarded to help surgeons with expenses

RUNNING TO KEEP STILL

The results of an unprecedented number of trials involving cardiac surgical ops have been published recently. Most have been in the NEJM here, here and here. Many, including the results of the Partner Cohort A trial  were announced for the first time at the recent annual meeting of the American College of Cardiology. I have commented on the results of the Partner trial in my last post. Many of these trials have

MASSA CARRARA

Last March, I was awarded the Ionescu scholarship by the Society of Cardiothoracic Surgeons of Great Britain and Ireland. The funds for this scholarship were bequeathed to the society by Marian Ionescu (Wikipedia entry). The scholarship is awarded to help surgeons visit other units to learn new