{"title":"Surgery, innovation, research and sustainable development","authors":"Karem Slim , Frédéric Martin","doi":"10.1016/j.jviscsurg.2023.10.005","DOIUrl":"10.1016/j.jviscsurg.2023.10.005","url":null,"abstract":"<div><p><span>In the healthcare sector, surgery (especially in the operating theatre) is responsible for emission of greenhouse gases, which is a source of global warming. The goal of this largely quantitative assessment is to address three questions on carbon footprint associated with surgery, the role of primary and secondary prevention prior to surgical procedures, and incorporation of the carbon footprint into judgment criteria in research and surgical innovations. It appears that while the impact of surgery on global warming is undeniable, its extent depends on means of treatment and geographical location. Before and after an operation, primary, secondary and </span>tertiary prevention accompanied by surgical sobriety (avoiding unnecessary or unjustified actions) can be virtuous in terms of sustainable development. However, the sanitary benefits of these actions are often opposed to environmental benefit, which has yet to be satisfactorily assessed. Lastly, the carbon footprint has yet to be incorporated into research protocols or the innovations under development. This should impel us not only to sensitize the different healthcare actors to relevant issues, but also to improve working conditions.</p></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 2","pages":"Pages 63-68"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138554836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ninon Rouvière , Maria Pitard , Etienne Boutry , Michel Prudhomme , Martin Bertrand , Géraldine Leguelinel-Blache , Virginie Chasseigne
{"title":"How a hospital pharmacist can contribute to a more sustainable operating theater","authors":"Ninon Rouvière , Maria Pitard , Etienne Boutry , Michel Prudhomme , Martin Bertrand , Géraldine Leguelinel-Blache , Virginie Chasseigne","doi":"10.1016/j.jviscsurg.2023.11.004","DOIUrl":"10.1016/j.jviscsurg.2023.11.004","url":null,"abstract":"<div><p>Healthcare sectors, particularly operating theaters, are major consumers of resources. Given today's climate-related issues, its seems vital that the different healthcare professionals in operating areas become aware of their roles. This is pronouncedly the case for hospital pharmacists, who fulfill cross-sectional functions in the proper use and management of healthcare products and sterile medical devices. The objective of this review of the literature is to identify the actions a hospital pharmacist can take to impel evolution toward ecologically responsible care in the operating theater. Seven areas in which a pharmacist can assume a leading, supporting or composite role in rendering an operating theater ecologically responsible have been highlighted: purchasing, procurement and storage, harmonization of practices, modification of practices, professional attire, waste elimination and research/teaching. The active participation of all healthcare professionals, including the hospital pharmacist, is essential to the development of a sustainable approach to healthcare.</p></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 2","pages":"Pages 37-45"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138684089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ileosigmoid knotting, a rare but serious cause of intestinal obstruction","authors":"Elena Belloni, Camélia Labiad, Gilles Manceau","doi":"10.1016/j.jviscsurg.2023.12.007","DOIUrl":"10.1016/j.jviscsurg.2023.12.007","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 2","pages":"Pages 156-157"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benoît Romain, French Society of Wall Surgery-Club Hernia (SFCP-CH)
{"title":"Component separation techniques on the abdominal wall: “A word of caution”","authors":"Benoît Romain, French Society of Wall Surgery-Club Hernia (SFCP-CH)","doi":"10.1016/j.jviscsurg.2023.11.012","DOIUrl":"10.1016/j.jviscsurg.2023.11.012","url":null,"abstract":"","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 2","pages":"Pages 74-75"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138554771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Kabanova , Charles Moret , Pierre Albaladejo , Karem Slim
{"title":"Is a care pathway for enhanced recovery after colorectal surgery environmentally responsible?","authors":"Diana Kabanova , Charles Moret , Pierre Albaladejo , Karem Slim","doi":"10.1016/j.jviscsurg.2023.10.008","DOIUrl":"10.1016/j.jviscsurg.2023.10.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Above and beyond the environmentally responsible operating theater, the environmental impact of the pathways of surgically treated patients seems essential but has seldom been considered in the literature. On a parallel track, enhanced recovery programmes (ERP) programs are presently deemed a standard of care. The objective of this review is to determine the carbon footprint of the ERP approach in colorectal surgery.</p></div><div><h3>Method</h3><p>This a narrative review based on articles referenced in PubMed. Our search was centered on the environmental impact of an ERP in the context of colorectal surgery. A number of measures included in the national and international guidelines were studied. We utilized the terms “carbon footprint”, “sustainability”, “energy cost”, “environmental footprint”, “life cycle assessment” AND a key word for each subject found in the ERP recommendations.</p></div><div><h3>Results</h3><p>Most ERP measures in the context of colorectal surgery are factually or intuitively virtuous from an ecological standpoint. With a 3-day reduction in average hospital stay resulting from ERP, the program permits a reduction of at least 375<!--> <!-->kg CO<sub>2</sub><span><span>e/patient (Appendices 1 and 2). The most substantial part of this reduction is achieved during the perioperative period<span>. While some measures, such as short fasting, are ecologically neutral, others (treatment of comorbidities, smoking cessation<span>, hypothermia prevention, antibiotic prophylaxis, laparoscopy, absence of drains or probes, </span></span></span>thromboprophylaxis<span><span>, early feeding and mobilization…) lead to fewer postoperative complications, and can consequently be considered as environmentally responsible. Conversely, other measures, one example being </span>robotic surgery, leave a substantial carbon footprint.</span></span></p></div><div><h3>Conclusion</h3><p>ERP is congruent with two pillars of sustainable development: the social pillar (improved patient recovery, and better caregiver working conditions fostered by team spirit), and the economic pillar (decreased healthcare expenses). While the third, environmental pillar is intuitively present, the low number of published studies remains a limitation to be overcome in future qualitative studies.</p></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 2","pages":"Pages 46-53"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138741687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jérôme Brunet, Clément Billaquois, Hugo Viellard, Franck Courari
{"title":"Eco-friendly hospital architecture","authors":"Jérôme Brunet, Clément Billaquois, Hugo Viellard, Franck Courari","doi":"10.1016/j.jviscsurg.2023.11.008","DOIUrl":"10.1016/j.jviscsurg.2023.11.008","url":null,"abstract":"<div><p>Following a reminder on the quantities of carbon emitted in the healthcare sector, and casting a spotlight on those directly related to architecture, the authors of this article will develop three large-scale themes, the objective being to render hospital construction sustainable. 1. Energy consumption and how to reduce it. 2. “Low-carbon” construction and how building designers can limit emissions by the choice of construction materials. 3. The “resilience” of some constructions, their capacity to stave off obsolescence. As a conclusion, the authors present one of the most recent projects of the Brunet Saunier & Associates architecture agency: the Saint-Ouen university hospital, Grand Paris Nord. This project is illustrative of these preoccupations and demonstrates the possibility of meeting the challenges of sustainable development by means of simple and durable architecture.</p></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 2","pages":"Pages 54-62"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139555628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mathilde Aubert , Etienne Buscail , Emilie Duchalais , Antoine Cazelles , Maxime Collard , Diane Charleux-Muller , Florence Jeune , Alexandre Nuzzo , Alexandra Pellegrin , Luca Theuil , Amandine Toutain , Bertrand Trilling , Laurent Siproudhis , Guillaume Meurette , Jérémie H. Lefevre , Léon Maggiori , Diane Mege , sous l’égide de la Société nationale française de coloproctologie (SNFCP) et de la Société française de chirurgie digestive (SFCD)
{"title":"Management of adult intestinal stomas: The 2023 French guidelines","authors":"Mathilde Aubert , Etienne Buscail , Emilie Duchalais , Antoine Cazelles , Maxime Collard , Diane Charleux-Muller , Florence Jeune , Alexandre Nuzzo , Alexandra Pellegrin , Luca Theuil , Amandine Toutain , Bertrand Trilling , Laurent Siproudhis , Guillaume Meurette , Jérémie H. Lefevre , Léon Maggiori , Diane Mege , sous l’égide de la Société nationale française de coloproctologie (SNFCP) et de la Société française de chirurgie digestive (SFCD)","doi":"10.1016/j.jviscsurg.2024.02.002","DOIUrl":"10.1016/j.jviscsurg.2024.02.002","url":null,"abstract":"<div><h3>Aim</h3><p>Digestive stoma are frequently performed. The last French guidelines have been published twenty years ago. Our aim was to update French clinical practice guidelines for the perioperative management of digestive stoma and stoma-related complications.</p></div><div><h3>Methods</h3><p>A systematic literature review of French and English articles published between January 2000 and May 2022 was performed. Only digestive stoma for fecal evacuation in adults were considered. Stoma in children, urinary stoma, digestive stoma for enteral nutrition, and rare stoma (Koch, perineal) were not included.</p></div><div><h3>Results</h3><p>Guidelines include the surgical landmarks to create digestive stoma (ideal location, mucocutaneous anastomosis, utility of support rods, use of prophylactic mesh), the perioperative clinical practice guidelines (patient education, preoperative ostomy site marking, postoperative equipment, prescriptions, and follow-up), the management of early stoma-related complications (difficulties for nursing, high output, stoma necrosis, retraction, abscess and peristomal skin complications), and the management of late stoma-related complications (stoma prolapse, parastomal hernia, stoma stenosis, late stoma retraction). A level of evidence was assigned to each statement.</p></div><div><h3>Conclusion</h3><p>These guidelines will be very useful in clinical practice, and allow to delete some outdated dogma.</p></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 2","pages":"Pages 106-128"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140050733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Dohner , F. Kierdorf , P. Moreno , R. Langer , M. Zuber , R. Fahrner
{"title":"Neurogenic appendicopathy: A rare differential diagnosis of acute appendicitis","authors":"E. Dohner , F. Kierdorf , P. Moreno , R. Langer , M. Zuber , R. Fahrner","doi":"10.1016/j.jviscsurg.2023.02.006","DOIUrl":"10.1016/j.jviscsurg.2023.02.006","url":null,"abstract":"<div><h3>Aim of the study</h3><p>In histologically non-inflamed but clinically suspect appendices, changes described as neurogenic appendicopathy with fibrous or fibrolipomatous obliterations can be observed. The purpose of this study was to analyse the incidence of these entities of the appendix in a longitudinal patient cohort.</p></div><div><h3>Patients and methods</h3><p>This is a retrospective single-centre study of 457 patients undergoing laparoscopic appendectomy<span> from 2017 to 2020 due to suspected acute appendicitis.</span></p></div><div><h3>Results</h3><p>In 72 patients (15.8%) with clinically suspected acute appendicitis, the appendix showed no distinct signs of acute inflammation during the procedure. In 43 patients, histological analysis revealed neurogenic appendicopathy or fibrous and fibrolipomatous obliteration. Female gender (<em>P</em> <!-->=<!--> <!-->0.088), younger age (<em>P</em> <!--><<!--> <!-->0.0001), longer pain duration (<em>P</em> <!--><<!--> <!-->0.0001) and repetitive pain episodes were more frequent in these patients than in those with acute appendicitis. Inflammation markers were also decreased in the group of patients with neurogenic appendicopathy (leukocytes 9.8<!--> <!-->±<!--> <!-->3.5 vs. 13.0<!--> <!-->±<!--> <!-->4.5 G/L and C-reactive protein 38.7<!--> <!-->±<!--> <!-->60.7 vs. 59.4<!--> <!-->±<!--> <!-->70.5<!--> <!-->mg/L).</p></div><div><h3>Conclusion</h3><p>Neurogenic appendicopathy with fibrous/fibrolipomatous obliteration is a differential diagnosis of acute appendicitis that can only be confirmed by pathology. Female gender, young age, prolonged duration with repetitive episodes of pain, and relatively low inflammatory markers are evocative of this diagnosis.</p></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 1","pages":"Pages 15-20"},"PeriodicalIF":2.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10774062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Asymptomatic gastric band migration","authors":"Ymer Durmishi, Floren Kavaja","doi":"10.1016/j.jviscsurg.2023.12.005","DOIUrl":"10.1016/j.jviscsurg.2023.12.005","url":null,"abstract":"<div><p>Gastric band migration, for which abscess of the subcutaneous port<span> is an alarm signal, can in some cases be asymptomatic. Therapeutic options for withdrawal of the migrated band include colonoscopy (if the band is located at the level of the ileo-caecal valve), laparoscopy and mini-laparotomy.</span></p></div>","PeriodicalId":49271,"journal":{"name":"Journal of Visceral Surgery","volume":"161 1","pages":"Pages 70-71"},"PeriodicalIF":2.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}