General Surgery News

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CONVENTION ISSUE:

Pre-American College of Surgeons Clinical Congress

GENERALSURGERYNEWS.COM

September 2013 • Volume 40 • Number 9

The Independent Monthly Newspaper for the General Surgeon

Opinion

Endoscopic Procedures Control Reflux Well in Trials

Scopes II B Y D AVID C OSSMAN , MD

I

n a celebrated legal case in 1925, charges were brought against a high school teacher, John Thomas Scopes, for violating the Butler Actt that outlawed the teaching of evolution in public schools in Tennessee. Scopes was a substitute teacher who collaborated with the American Civil Liberties Union (ACLU) to purposefully violate the “creationism only” law to draw public attention to the state of education in the Bible belt. Scopes—represented by Clarence Darrow—lost, and had to pay $100, but the decision was reversed on appeal and the rest is, as they say, history. But not quite. The world is a different place now. I fully expect the ACLU to reverse course, and petition the school boards to delete the study of evolution from high school curricula. Although Darwinism and its central theses might have resonated with a robust and

The Endo GIA ATM Radial Reload With Tri-StapleTM Technology For HAL LAR

Axilla Radiotherapy Called New Breast Cancer Standard

B Y T ED B OSWORTH

B Y T ED B OSWORTH

ORLANDO, FLA.—Data on two endoscopic procedures for treating gastroesophageal reflux disease (GERD) show that the procedures are capable of eliminating, or greatly reducing, dependence on proton pump inhibitor (PPI) therapy. Findings were presented at the 2013 Digestive Disease Week meeting. One of the procedures, EsophyX2, a transoral fundoplication technique, has outcome data available for six months post-procedure. The other procedure, Stretta, a radiofrequency technique that augments the integrity of the

CHICAGO—In patients with early-stage invasive breast cancer with a positive sentinel node, axillary radiotherapy (AxRT) provides comparable protection against relapse but a lower risk for lymphedema relative to axillary lymph node dissection (ALND), according to results of a randomized trial with a median follow-up of more than six years. Although the trial was ultimately underp powered because of an unexpecctedly low rate of relapse in both arrms, the results were still charaacterized as practice-changing. “Both axillary lymph node dissection and axillary radiottherapy provide excellent and coomparable locoregional control in b breast cancer patients with positive sentinel s nodes, but radiotherapy produces less edema and can be considered the standard,” said lead author Emiel J. Rutgers, MD, PhD, a surgical oncologist at Netherlands Cancer Institute in Amsterdam. In the European Organisation for

see ANTIREFLUX PAGEE 18

see SCOPES II page 34

PROCEDURAL BREAKTHROUGH

®

In Study, Transvaginal NOTES Causes No Sexual Dysfunction B Y M ONICA J. S MITH

see RADIOTHERAPY page 33

see page 6

REPORT Clinical Performance and Economic Analysis of GORE® BIO-A® Tissue Reinforcement See insert at page 20

BALTIMORE—A recent small study finding that natural orifice transluminal endoscopic surgery (NOTES) through the vagina does not affect sexual function or the patient’s ability to deliver a baby vaginally, and reduces postoperative pain and the risk for

INSIDE Code of the Month

Stitches

On the Spot

10

13

28

Are We Treating the Whole Patient? The Importance of Specificity of Diagnosis

A Talk With Eddie Joe Reddick, MD: Laparoscopy Pioneer, Recording Artist

The Art of Herniology, Part 2: randomized trials; sportsman hernia; lightweight, large-pore synthetic mesh vs. biologic mesh

complications, may assuage the concerns of some providers and patients. “NOTES surgery provides an obvious aesthetic advantage and a potential to reduce trocar site complications; still, many potential patients see NOTES page 25

REPORT Teflaro® (ceftaroline fosamil) for the Treatment of Community-Acquired Bacterial Pneumonia Caused by Designated Susceptible Bacteria See insert at page 28


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